Evidence map›Paper›PMID 40887140›Full record

ArticleBMJ case reports2025

Suspected capecitabine-induced fatal toxicity in the context of a new DPYD variant.

Phu Ngone Thet, Taha Khalid, Rosalind Ganderton, Timothy Iveson

Abstract readCase Reports
In one paragraph

Article in BMJ case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Phu Ngone ThetGastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK phungonethet@gmail.com.
Taha KhalidMedical oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID http://orcid.org/0000-0002-5269-1160
Rosalind GandertonWessex genomic laboratory service, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Timothy IvesonMedical oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We present the case of a male in his early 70s who died after receiving adjuvant chemotherapy, probably due to an undiagnosed dihydropyrimidine dehydrogenase (DPYD) deficiency. Despite normal results from standard DPYD genotyping prior to treatment, he developed severe gastrointestinal toxicity that progressed to bowel ischaemia and ultimately death. This case underscores the potential limitations of current genotyping approaches, which may not detect rare or functionally significant DPYD variants. It also highlights the need for a cautious and comprehensive approach to fluoropyrimidine therapy, especially in patients who develop unexpected toxicity, while recognising that other contributing factors may be involved.

Indexed as

Antimetabolites, AntineoplasticCapecitabineDihydropyrimidine Dehydrogenase DeficiencyDihydrouracil Dehydrogenase (NADP)AgedChemotherapy, AdjuvantFatal OutcomeHumansMaleAntimetabolites, AntineoplasticCapecitabineDihydrouracil Dehydrogenase (NADP)Cancer - see OncologyGenetic screening / counselling

Identifiers

PMID40887140
PMCPMC12406298

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.