Affiliation:
1. Department of Medical Oncology , SofiaMed University Multiprofile Hospital for Active Treatment
Abstract
Summary
The article presents a detailed survey of recent publications in the literature concerning clinical expertise, existing guidelines, and differing opinions on Fluoropyrimidine chemotherapy-related toxicity and the implication of Dihydropyrimidine dehydrogenase (DPD) screening aiming to prevent severe 5-Fluorouracil-induced adverse drug reactions. The first section provides information on the mechanism of action, clinical application, pharmacokinetics and pharmacodynamics, and toxicity and adverse reactions of 5-Fluorouracil, Capecitabine, Floxuridine, and Flucytosine.
The second section summarizes DPD phenol- and genotype data and provides reasons for determining a DPD life-threatening complete or partial enzyme deficiency. The pros and cons of the methodological approaches for DPD screening are analysed, and recommendations are made to introduce them into clinical practice.
The third section includes a brief economic analysis of expenses for DPD screening of patients scheduled for 5-Fluorouracil chemotherapy. The costs are compared to those related to the treatment of patients suffering from 5-Fluorouracil-induced toxicity and unwanted adverse effects.
Reference47 articles.
1. 1. Chabner BA. General principles of cancer chemotherapy. In: Brunton L, Chabner B, Knollmman B, editors. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. New York: McGraw Hill Medical. 2011;60:1667-75.
2. 2. Romond EH, Perez EA, Bryant J. Transtuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353:1673-84.10.1056/NEJMoa052122
3. 3. Batchelor TA, Sorensen AG, Di Tomaso E. AZD2171, a pan-VAGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients. Cancer Cell. 2007;11:3-95.10.1016/j.ccr.2006.11.021
4. 4. Holleman A, Den Boer ML, De Menezes RX. The expression of 70 apoptosis genes in relation to lineage, genetic subtype, cellular drug resistance, and outcome in childhood lymphoblastic leukemia. Blood. 2006;107:769-76.10.1182/blood-2005-07-2930
5. 5. Preusser M, De Mattos-Arrude L, Thill M, Criscitiello C, Bartsch R, Ruhstaller T, De Azambuja E, Zielinski CC. CDK4/6 inhibitors in the treatment of patients with breast cancer: summary of a multidisciplinary round-table discussion. ESMO Open. 2018;3:1-19.10.1136/esmoopen-2018-000368
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献