Topics:
Gastrointestinal Cancers • Medical Oncology
How do you approach a patient with DPD deficiency that experiences severe toxicity on 5-FU despite dose reduction in the setting of metastatic colorectal cancer?
Answer from: Medical Oncologist at Community Practice
This depends on the mutation. Most patients heterozygous for DPYD mutations can be treated with dose-reduced 5-FU or capecitabine. Guidelines from CPIC (Clinical Pharmacogenomics Implementation Consortium) give recommended dose reductions for specific genotypes - a 50% dose reduction is appropriate ...
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Answer from: Medical Oncologist at Community Practice
Unfortunately, this represents a contraindication to further 5FU. One would need to either utilize IROX or irinotecan alone in combination with antibody therapy. Further, it is not clear whether TAS-102 is a safe agent in this setting. Thus, this patient's options are very limited given their underl...
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Medical Oncologist at Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center
Heterozygous DPYD mutations are not necessarily a ...
Heterozygous DPYD mutations are not necessarily a ...