Please select the option that best describes you:
Do you regularly perform pharmacogenomic testing for patients prior to starting chemotherapy?
For either patients in general or for patients who will receive regimens with well-described toxicities such as irinotecan/UGT1A1.
If so, do you request testing for specific genes, or do you typically request a panel?
Answer from: Medical Oncologist at Community Practice
Because fluoropyrimidines are a pillar of therapy in colorectal cancer and it is not known with certainty that given dihydropyrimidine dehydrogenase (DPYD) variants are associated with high risk and/or that dose adjustments do not impact treatment efficacy, universal pretreatment DPYD genotyping is ...
Answer from: Medical Oncologist at Academic Institution
I do not test for either DYPD mutation or UGTA1A variants. The presence of UGTA1A variant may result in slightly higher neutropenia, but this is less than interpatient variability and can be addressed by appropriate dose reduction.Regarding DYPD, this is an important issue due to potential fatal tox...
Comments
Medical Oncologist at Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center
It is worth noting that the great majority of fata...
It is worth noting that the great majority of fata...
Answer from: Medical Oncologist at Academic Institution
I am routinely offering DPYD testing prior to starting patients on fluoropyrimidines but we do not have an institutional policy. While I agree with the argument that more data are needed on the dose adjustments in patients with DPYD variants, I feel more comfortable knowing the genotype and prefer t...
Answer from: Medical Oncologist at Community Practice
Both answers above from Dr. @Mehmet Sitki Copur and Dr @Gabriel A. Brooks represents the sides of the spectrum of this debate in practice in the United States. Practically, I can say I have been trying to send the Mayo Clinic Panel (https://www.mayocliniclabs.com/test-catalog/overview/610063#Specime...
Good for academic centers, but not practical in a ...