Ethnic Diversity of DPD Activity and the DPYD Gene: Review of the Literature.
Cassandra WhiteRodney J ScottChristine PaulAndrew ZiolkowskiDavid MossmanStephen AcklandPublished in: Pharmacogenomics and personalized medicine (2021)
Pharmacogenomic screening can identify patients with gene variants that predispose them to the development of severe toxicity from fluoropyrimidine (FP) chemotherapy. Deficiency of the critical metabolic enzyme dihydropyrimidine dehydrogenase (DPD) leads to excessive toxicity on exposure to fluoropyrimidine chemotherapy. This can result in hospitalisation, intensive care admissions and even death. Upfront screening of the gene that encodes for DPD ( DPYD ) has recently been implemented in regions throughout Europe and the United Kingdom. Current screening evaluates DPYD variants that are well described within Caucasian patient populations and provides genotyped-guided dose adjustment recommendations based upon the presence of these variants. This article reviews the differences in DPYD gene variants within non-Caucasian populations compared to Caucasian populations, with regard to the implications for clinical tolerance of fluoropyrimidine chemotherapies and genotype guided dose adjustment guidelines.
Keyphrases
- copy number
- genome wide
- genome wide identification
- dna methylation
- african american
- clinical practice
- randomized controlled trial
- locally advanced
- early onset
- case report
- genetic diversity
- radiation therapy
- transcription factor
- body mass index
- genome wide analysis
- drug induced
- clinical decision support
- rectal cancer