CPIC Guideline Update: DPYD and Fluoropyrimidines

The 2017 update of the CPIC Guideline for Fluoropyrimidines and DPYD is now available as an advance online publication in Clinical Pharmacology and Therapeutics. CPIC extensively reviewed the literature up to March 2017. Both the dosing recommendations and supplemental information were updated. The accepted article can currently be viewed on the PharmGKB pages for capecitabine and fluorouracil, and the CPIC website. 

Fluoropyrimidines are mainly used to treat solid tumors, such as colorectal, breast and aerodigestive cancers. Dihydropyrimidine dehydrogenase (DPD, encoded by the DPYD gene) is the rate-limiting enzyme for fluoropyrimidine metabolism and is therefore responsible for the detoxification of these types of drugs. The 2017 update includes the following updates and additions:

• Dosing recommendations were modified to only apply to fluorouracil and capecitabine; they no longer apply to tegafur.
• Dosing recommendations are now given in the context of DPYD activity score.

For further details see the guidelines and supplement on CPIC, or on the pages for capecitabine and fluorouracil on PharmGKB.