부산대학교 도서관

Background: Dihydropyrimidine dehydrogenase (DPD) testing is nationally mandated prior to receiving fluoropyrimidine chemotherapy to identify individuals with an inter-individual genetic variation that puts them at an increased risk of severe toxicity.1,2 This project aimed to assess the implementation of DPD testing and investigate whether testing has reduced toxicity. Methods: A retrospective search of a prospectivelymaintained database identified two cohorts of patients who received fluoropyrimidine chemotherapy (5-fluorouracil or capecitabine) at The Bristol Haematology and Oncology Centre (BHOC); a pre-testing cohort from April to August 2019 and a post-DPD testing cohort from February to May 2021. Patient data were collected using electronic prescribing and noting systems. Results: In the post-test cohort, 100% (92 patients) had a DPD test with 96% (88 patients) receiving results prior to starting chemotherapy. A DPD variant was identified in 10% (nine patients, all heterozygous) with all doses being appropriately reduced except for one patient where chemotherapy was started prior to the result being available. The mean turnaround time, counted in days from blood draw to result available, was 3 days (range: 1–8). In the pre-DPD cohort, 29% of patients reported diarrhoea in comparison to 40% in the post-testing cohort. In the pre-testing cohort, 7% of patients were admitted to the hospital due to any significant toxicity with a median length of stay (mLOS) of 4.5 days, whereas 10% of the post-testing cohort were admitted with an mLOS of 3 days. Discussion: Our results have confirmed complete compliance at the BHOC for DPD testing in accordance with the national recommendation. Time to receive a DPD result is short but we aim to improve the process by moving to electronic requesting and receipt of results. Within this cohort, there was no apparent reduction in toxicity although mLOS was reduced. We plan to combine our data with other local centres to more accurately reflect the impact that testing has had on clinical practice. [ABSTRACT FROM AUTHOR]