DPD for 5-fluorouracil toxicity
Fluoropyrimidines (5-fluorouracil, capecitabine and tegafur) are chemotherapy drugs used to treat certain cancers. Treatment with fluoropyrimidines is generally well tolerated. However, 3-6% of patients suffer serious adverse drug reactions as a result of genetic variation in their DPYD gene which means they are unable to properly metabolise and breakdown these drugs. Genetic testing for the common DPYD genetic variants is recommended in some cancer patients. Although the test does not remove all treatment risk, it does reduce the incidence of toxicity.
Since November 2020 testing for common DPYD polymorphisms with robust evidence of association with fluoropyrimidine-toxicity are available via the Cancer test directory following the publication of the Clinical Commissioning Urgent Policy Statement Pharmacogenomic testing for DPYD polymorphisms with fluoropyrimidine therapies. Testing is centrally funded and offered via local Genomic Laboratory Hubs (GLHs).
Currently testing for patients in the East GLH region has been performed by the Purine Research Laboratory in Biochemical Sciences lab at St Thomas’ Hospital, London.
From the 6th of April 2021 the East GLH testing will be provided by Cambridge Genomic Laboratory at Cambridge University Hospital (CUH). To ensure a rapid service, please submit samples directly to the laboratory by first class post or courier.
Important: Please use our updated referral paperwork specific to DPYD (link) choosing the appropriate clinical indication from the list and providing a routinely monitored secure email address for return of results.