Connect Sign In
FeedbackDPYD is the gene encoding dihydropyrimidine dehydrogenase (DPD), the rate-limiting enzyme for fluoropyrimidine catabolism (eg, for 5-FU). Genetic polymorphisms in DPYD affect drug metabolism. Between 10% and 40% of patients develop severe toxicity (neutropenia, nausea, vomiting, severe diarrhea, stomatitis, mucositis, hand-foot syndrome) and sometimes, death. Hospitalization risk from chemotherapy-induced neutropenia and diarrhea is heightened in people carrying genotypes predicted to be DPYD poor metabolizers (PMs).
Guide chemotherapy drug and dose selection by DPYD genotyping (2012166) to reduce hospitalization and fatality risk from severe neutropenia, diarrhea, and cutaneous reactions.
CPIC Guideline for Fluoropyrimidines and DPYD
Clinical Pharmacogenetics Implementation Consortium. CPIC guideline for fluoropyrimidines and DPYD. Updated Feb 2020; accessed Jul 2022.
24923815
Froehlich TK, Amstutz U, Aebi S, et al. Clinical importance of risk variants in the dihydropyrimidine dehydrogenase gene for the prediction of early-onset fluoropyrimidine toxicity. Int J Cancer. 2015;136(3):730-739.
25381393
Lee AM, Shi Q, Pavey E, et al. DPYD variants as predictors of 5-fluorouracil toxicity in adjuvant colon cancer treatment (NCCTG N0147). J Natl Cancer Inst. 2014;106(12):dju298.
26603945
Meulendijks D, Henricks LM, Sonke GS, et al. Clinical relevance of DPYD variants c.1679T>G, c.1236G>A/HapB3, and c.1601G>A as predictors of severe fluoropyrimidine-associated toxicity: a systematic review and meta-analysis of individual patient data. Lancet Oncol. 2015;16(16):1639-1650.