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Cancer treatments

A  DPYD A TEST PRIOR TO INFUSION OF 5FU  and similar chemotherapy may prevent toxic adverse effects including stroke and fatalities.


NHS ENGLAND announced a policy statement effective from August 2020. 

The following is quoted from their web site. We can only hope all oncologists are aware of this. At least patients should be aware and should request the test. 5FU and others in the fluoropyrimidine therapies group are a very commonly used chemotherapy.

Information about pharmacogenomic testing for DPYD polymorphisms with fluoropyrimidine therapies Fluoropyrimidines (5-fluorouracil, capecitabine and tegafur) are antimetabolite chemotherapy drugs which are used in the treatment of various cancers. Approximately 38,000 patients are initiated on fluoropyrimidine-based therapy each year in England (Public Health England, 2020). 

Click below for the Policy Statement:

Clinical Commissioning Urgent Policy Statement Pharmacogenomic testing for DPYD polymorphisms with fluoropyrimidine therapies [URN 1869] (200603P)

Pharmacogenomic testing for DPYD polymorphisms which cause dihydropyrimidine dehydrogenase (DPD) deficiency is recommended to be available through routine commissioning as a pre-treatment screening test prior to the administration of fluoropyrimidine- based therapies.

Three key clinical studies provide evidence of the clinical utility of DPYD testing to reduce the incidence of severe fluoropyrimidine-associated toxicity. 


Prsonal view and experience of Millie Kieve  (founder of APRIL) when caring for her sister:

Chemotherapy used for treating patients with cancer can be beneficial. We all known and are warned about some side-effects. However some toxic effects can be  Prevented with the use of pharmacogenomic knowledge.. 

The example I am concerned about is the use of 5 FU  which when first infused for my sister in California in 2015, it caused her to have an immediate stroke.

Not only did she lose the opportunity to receive further  treatment ,  her good quality of life until then was lost . She sadly became bed bound for the remaining few months of her life.

A test had been available long before this Policy Statement by the NHS, to check if she would tolerate the chemo. I discoverd in 2015 it was listed on the data sheet and recommended by the manufacture. The life saving test was not used in her case and was not being used in England  at a dedicated cancer hospital either, I also found.

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