ArticleFrontiers in pharmacology2019
DPD Testing Before Treatment With Fluoropyrimidines in the Amsterdam UMCs: An Evaluation of Current Pharmacogenetic Practice.
Article in Frontiers in pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Healthcare professionals' and consumers' knowledge, attitudes, perspectives, and education needs in oncology pharmacogenomics: A systematic review.Clinical and translational science · 2023Pooled it
- A blockchain-based framework to support pharmacogenetic data sharing.The pharmacogenomics journal · 2022Pooled it
- Global Investigation of Clinical Implementation Strategies for DPYD Testing to Guide Fluoropyrimidine Therapy.Clinical and translational science · 2026Article
- Large-Scale Pharmacogenomics Analysis of Patients With Cancer Within the 100,000 Genomes Project Combining Whole-Genome Sequencing and Medical Records to Inform Clinical Practice.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Implementation of pre-emptive testing of a pharmacogenomic panel in clinical practice: Where do we stand?British journal of clinical pharmacology · 2025Review
- Capecitabine-induced severe adverse events-therapeutic drug monitoring andBMJ case reports · 2024Article
- Determination of plasma uracil as a screening for dihydropyrimidine dehydrogenase deficiency: clinical application in oncological treatments.European journal of hospital pharmacy : science and practice · 2024Observational
- Engagement of patients and the public in personalised prevention in Europe using genomic information: a scoping review.Frontiers in public health · 2024Article
- Practical Consensus Guidelines for the Use of S-1 in GI Malignancies.South Asian journal of cancer · 2024Article
- Patient and healthcare professional acceptability of pharmacogenetic screening for DPYD and UGT1A1: A cross sectional survey.Clinical and translational science · 2023Article
- Pharmacogenomics implementation across multiple clinic settings: a qualitative evaluation.Pharmacogenomics · 2023Article
- Awareness and attitudes of oncology specialists toward dihydropyrimidine dehydrogenase testing in Saudi Arabia.Cancer reports (Hoboken, N.J.) · 2023Article
- Pharmacogenomic-guided dosing of fluoropyrimidines beyondFrontiers in pharmacology · 2023Review
- Ten-year experience with pharmacogenetic testing forFrontiers in pharmacology · 2023Article
- Implementing pharmacogenetic testing in fluoropyrimidine-treated cancer patients:Frontiers in pharmacology · 2023Article
- Pharmacogenomics in the era of personalised medicine.The Medical journal of Australia · 2022Article
- Testing for Dihydropyrimidine Dehydrogenase Deficiency to Individualize 5-Fluorouracil Therapy.Cancers · 2022Review
- Survey of US Medical Oncologists' Practices and Beliefs RegardingJCO oncology practice · 2022Article
- Fast, Direct Dihydrouracil Quantitation in Human Saliva: Method Development, Validation, and Application.International journal of environmental research and public health · 2022Article
- The Value of Pharmacogenetics to Reduce Drug-Related Toxicity in Cancer Patients.Molecular diagnosis & therapy · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe fluoropyrimidines (FP) (5-Fluorouracil, capecitabine, and tegafur) are commonly used anti-cancer drugs, but lead to moderate to severe toxicity in about 10-40% of patients. DPD testing [either the enzyme activity of dihydropyrimidine dehydrogenase (DPD) or the MATERIALS AND
methodsWe used a mixed-method approach involving electronic patient records of 753 unique patients and pharmacy information systems analyses and fifteen semi-structured interviews with oncologists, pharmacists, and patients. The constellation perspective was used to identify barriers and facilitators at the level of practice, culture and structure. The proportion of FP users who were DPD tested pretreatment showed an increase from 1% (1/86) in Q2-2017 up to 87% (73/84) in Q4-2018. Unlike a landmark paper published in 2015, the National guideline for colorectal carcinoma followed by meetings to achieve local consensus led to this steep increase in the proportion of patients tested.
resultsFacilitating factors for stakeholders to implement testing included the existence of clear protocols, (anecdotal) evidence of the utility, being aware that peers are adhering to standard practice and clear and simple procedures for ordering and reporting. Main barriers included the lack of clear divisions of responsibilities, the lack of consensus on a test approach, long turn-around times and non-user-friendly IT-infrastructures. More professional education on the utility and limitations of pharmacogenetic testing was desired by most stakeholders.
conclusionWhile the evidence for DPD testing was sufficient, only after the update of a National guideline and local consensus meetings the proportion of FP users that were DPD tested pretreatment rose to 87%. The implementation of personalized medicine requires stakeholders involved to attune practice, culture and structure.
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