Dihydropyrimidine dehydrogenase deficiency screening for management of patients receiving a fluoropyrimidine: Results of two national practice surveys addressed to clinicians and biologists

Translated title of the contribution: Dihydropyrimidine dehydrogenase deficiency screening for management of patients receiving a fluoropyrimidine: Results of two national practice surveys addressed to clinicians and biologists

Marie Anne Loriot, Fadil Masskouri, Paolo Carni, Karine Le Malicot, Jean François Seitz, Pierre Michel, Jean Louis Legoux, Olivier Bouché, Thierry André, Roger Faroux, Suzette Delaloge, David Malka, Joel Guigay, Juliette Thariat, Fabienne Thomas, Chantal Barin-Le-Guellec, Joseph Ciccolini, Jean Christophe Boyer, Marie Christine Étienne-Grimaldi

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Dihydropyrimidine dehydrogenase (DPD) deficiency is the main cause of early severe toxicities induced by fluoropyrimidines (FP). The French Group of Clinical Oncopharmacology (GPCO)-Unicancer and the French Pharmacogenetics Network (RNPGx) initiated two surveys, one addressed to oncologists, the other to biologists, in order to evaluate routine practices regarding DPD deficiency screening at national level, as well as compliance, motivations and obstacles for implementation of these tests. These anonymized online surveys were performed with the logistic assistance of the Francophone Federation of Digestive Oncology (FFCD) and the support of numerous medical and biological societies. The surveys were conducted in 2016–2017 before the creation of the French INCa/HAS expert panel, which contributed to the drafting of rules and recommendations for DPD deficiency screening published in December 2018. In all, 554 questionnaires from clinicians were analyzed (23% participation) and 35 from biologists. The main arguments raised by clinicians for justifying the limited practice of DPD deficiency screening were: the lack of recommendations from medical societies or Health Authorities, delays in obtaining results, and the lack of adequate reimbursement by the health insurance system. The goal of these surveys was to provide the French Health Authorities with an overview on nationwide DPD-deficiency screening practices and thus help to design recommendations for the standardization and improvement of the management and safety of cancer patients receiving FP-based chemotherapy.

Translated title of the contributionDihydropyrimidine dehydrogenase deficiency screening for management of patients receiving a fluoropyrimidine: Results of two national practice surveys addressed to clinicians and biologists
Original languageFrench
Pages (from-to)759-775
Number of pages17
JournalBulletin du Cancer
Volume106
Issue number9
DOIs
StatePublished - Sep 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 Société Française du Cancer

Funding

Ces enquêtes ont été réalisées avec le soutien financier du ministère de la Santé dans le cadre d'un programme hospitalier de recherche clinique (PHRC-K 14-193 FUSAFE, M.C. Etienne-Grimaldi coordinateur). Les auteurs remercient l'ensemble des médecins et leurs fédérations pour leur soutien et leur disponibilité, en particulier Cécile Girault, Marie Moreau, Daniel Gonzalez et Romain Coriat pour la FFCD; Christophe Louvet, Dominique Notelet, Myriam Lamoury et Christine Delpeut pour le GERCOR; Claire Jouffroy et Angele Yougye pour Unicancer-GI; J. Lemonnier, S. Touitou et Sara Garcia pour Unicancer-BG; Khadija Cherif, Camille Dao et Jessy Delaye pour Unicancer-ORL; et Jean Bourhis pour le GORTEC. Les auteurs remercient également l'ensemble des biologistes pour leur adhésion, en particulier Benoît Arveiler pour l'ANPGM; Frédéric Libert pour le groupe STP de la SFPT; Bernard Royer pour le GPCO; Laurent Becquemont et Christelle Julien pour le RNPGx; Nicole Coupré pour BIOMNIS. Pour la validation de l'enquête clinicien (phase test) nous remercions Françoise Bavoux et Sarra Dalibey (Service de Pharmacovigilance de l'Hôpital Cochin, Paris) ainsi que les membres du Comité de pilotage de l'axe 3 du PHRC FUSAFE : Thomas Aparicio (FFCD), Valérie Boige (UNICANCER), Thierry André (GERCOR), Roger Faroux (ANGH), Cédric Lecaille, Jean-François Seitz et Come Lepage.

FundersFunder number
ANGH
Bernard Royer pour le GPCO
Camille Dao et Jessy Delaye pour Unicancer-ORL
Khadija Cherif
Nicole Coupré pour BIOMNIS
Roger Faroux
Valérie Boige
Unicancer
ministère de la Santé dans le cadre d'un programme hospitalier de recherche cliniquePHRC-K 14-193

    Keywords

    • DPD
    • Dihydropyrimidine dehydrogenase
    • Fluoropyrimidine
    • Screening
    • Surveys
    • Toxicity

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