Abstract
The fluoropyrimidines are the mainstay chemotherapeutic agents for the treatment of many types of cancers. Detoxifying metabolism of fluoropyrimidines requires dihydropyrimidine dehydrogenase (DPD, encoded by the DPYD gene), and reduced or absent activity of this enzyme can result in severe, and sometimes fatal, toxicity. We summarize evidence from the published literature supporting this association and provide dosing recommendations for fluoropyrimidines based on DPYD genotype (updates at http://www.pharmgkb.org).
Publication types
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Practice Guideline
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Antimetabolites, Antineoplastic / administration & dosage*
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Antimetabolites, Antineoplastic / adverse effects
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Capecitabine
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Deoxycytidine / administration & dosage
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Deoxycytidine / adverse effects
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Deoxycytidine / analogs & derivatives
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Dihydropyrimidine Dehydrogenase Deficiency / diagnosis
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Dihydropyrimidine Dehydrogenase Deficiency / genetics
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Dihydrouracil Dehydrogenase (NADP) / genetics*
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Female
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Fluorouracil / administration & dosage*
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Fluorouracil / adverse effects
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Fluorouracil / analogs & derivatives
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Genotype
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Humans
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Incidental Findings
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Male
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Risk Assessment
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Sex Factors
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Tegafur / administration & dosage
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Tegafur / adverse effects
Substances
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Antimetabolites, Antineoplastic
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Deoxycytidine
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Tegafur
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Capecitabine
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Dihydrouracil Dehydrogenase (NADP)
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Fluorouracil