Grand Rounds

Dihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen?

Wendy H. Vogel,(1) MSN, FNP, AOCNP®, Ahmed Minhas,(2) MD, and Steven Baumrucker,(1) MD

From (1)Wellmont Cancer Institute, Kingsport, Tennessee; (2)East Tennessee State University, Johnson City, Tennessee

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Wendy H. Vogel, MSN, FNP, AOCNP®, Wellmont Cancer Institute, 4485 West Stone Drive, Kingsport, TN 37660. E-mail: wendyvogel55@gmail.com


J Adv Pract Oncol 2020;11(1):68–73 | https://doi.org/10.6004/jadpro.2020.11.1.4 | © 2020 Harborside™


  

ABSTRACT

5-fluorouracil (5-FU) and its prodrug capecitabine are frequently prescribed in oncology. While usually well tolerated, toxicity can be severe, and even life-threatening. A dihydropyrimidine dehydrogenase (DPD) deficiency can cause severe toxicity. Current testing for DPD deficiency does not meet the criteria for a routine screening test prior to 5-FU therapy. A case study of a fatality secondary to capecitabine toxicity is reviewed and literature is examined regarding general screening for DPD deficiency. 




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