Is capecitabine safe in patients with gastrointestinal cancer and dihydropyrimidine dehydrogenase deficiency?

M. Wasif Saif, Robert B Diasio

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Patients with cancer with dihydropyrimidine dehydrogenase (DPD) deficiency are at significant risk for severe 5-fluorouracil (5-FU) toxicity, including the risk of death. Data regarding the toxicity of capecitabine, an oral fluoropyrimidine, in patients with DPD deficiency are scarce. From 2004 to 2005, 2 patients with gastrointestinal (GI) malignancies (of the pancreas and liver) experienced severe to even life-threatening toxicities during capecitabine therapy, which resulted in death for I patient. A DPD enzyme assay was performed as previously defined in our laboratory. Both patients were DPD deficient upon evaluation for toxicity. Capecitabine can lead to severe and sometimes life-threatening toxicities akin to toxicities caused by 5-FU in patients with DPD deficiency. In cases of unexpected severe toxicity during capecitabine treatment, DPD deficiency should be considered. We suggest that capecitabine should not be used in patients with DPD deficiency. Screening should be considered in view of the widespread use of capecitabine and 5-FU, the severe toxicity that can develop in patient with low DPD activity, and the prevalence of the mutation.

Original languageEnglish (US)
Pages (from-to)359-362
Number of pages4
JournalClinical Colorectal Cancer
Volume5
Issue number5
DOIs
StatePublished - 2006
Externally publishedYes

Fingerprint

Dihydropyrimidine Dehydrogenase Deficiency
Gastrointestinal Neoplasms
Dihydrouracil Dehydrogenase (NADP)
Fluorouracil
Capecitabine
Enzyme Assays
Pancreas
Neoplasms

Keywords

  • 5-Fluorouracil
  • Hand-foot syndrome
  • Klebsiella bacteremia
  • Toxicity

ASJC Scopus subject areas

  • Oncology

Cite this

Is capecitabine safe in patients with gastrointestinal cancer and dihydropyrimidine dehydrogenase deficiency? / Saif, M. Wasif; Diasio, Robert B.

In: Clinical Colorectal Cancer, Vol. 5, No. 5, 2006, p. 359-362.

Research output: Contribution to journalArticle

@article{1f3d1992a8d44bd78aae03fe32c43e74,
title = "Is capecitabine safe in patients with gastrointestinal cancer and dihydropyrimidine dehydrogenase deficiency?",
abstract = "Patients with cancer with dihydropyrimidine dehydrogenase (DPD) deficiency are at significant risk for severe 5-fluorouracil (5-FU) toxicity, including the risk of death. Data regarding the toxicity of capecitabine, an oral fluoropyrimidine, in patients with DPD deficiency are scarce. From 2004 to 2005, 2 patients with gastrointestinal (GI) malignancies (of the pancreas and liver) experienced severe to even life-threatening toxicities during capecitabine therapy, which resulted in death for I patient. A DPD enzyme assay was performed as previously defined in our laboratory. Both patients were DPD deficient upon evaluation for toxicity. Capecitabine can lead to severe and sometimes life-threatening toxicities akin to toxicities caused by 5-FU in patients with DPD deficiency. In cases of unexpected severe toxicity during capecitabine treatment, DPD deficiency should be considered. We suggest that capecitabine should not be used in patients with DPD deficiency. Screening should be considered in view of the widespread use of capecitabine and 5-FU, the severe toxicity that can develop in patient with low DPD activity, and the prevalence of the mutation.",
keywords = "5-Fluorouracil, Hand-foot syndrome, Klebsiella bacteremia, Toxicity",
author = "Saif, {M. Wasif} and Diasio, {Robert B}",
year = "2006",
doi = "10.3816/CCC.2006.n.007",
language = "English (US)",
volume = "5",
pages = "359--362",
journal = "Clinical Colorectal Cancer",
issn = "1533-0028",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Is capecitabine safe in patients with gastrointestinal cancer and dihydropyrimidine dehydrogenase deficiency?

AU - Saif, M. Wasif

AU - Diasio, Robert B

PY - 2006

Y1 - 2006

N2 - Patients with cancer with dihydropyrimidine dehydrogenase (DPD) deficiency are at significant risk for severe 5-fluorouracil (5-FU) toxicity, including the risk of death. Data regarding the toxicity of capecitabine, an oral fluoropyrimidine, in patients with DPD deficiency are scarce. From 2004 to 2005, 2 patients with gastrointestinal (GI) malignancies (of the pancreas and liver) experienced severe to even life-threatening toxicities during capecitabine therapy, which resulted in death for I patient. A DPD enzyme assay was performed as previously defined in our laboratory. Both patients were DPD deficient upon evaluation for toxicity. Capecitabine can lead to severe and sometimes life-threatening toxicities akin to toxicities caused by 5-FU in patients with DPD deficiency. In cases of unexpected severe toxicity during capecitabine treatment, DPD deficiency should be considered. We suggest that capecitabine should not be used in patients with DPD deficiency. Screening should be considered in view of the widespread use of capecitabine and 5-FU, the severe toxicity that can develop in patient with low DPD activity, and the prevalence of the mutation.

AB - Patients with cancer with dihydropyrimidine dehydrogenase (DPD) deficiency are at significant risk for severe 5-fluorouracil (5-FU) toxicity, including the risk of death. Data regarding the toxicity of capecitabine, an oral fluoropyrimidine, in patients with DPD deficiency are scarce. From 2004 to 2005, 2 patients with gastrointestinal (GI) malignancies (of the pancreas and liver) experienced severe to even life-threatening toxicities during capecitabine therapy, which resulted in death for I patient. A DPD enzyme assay was performed as previously defined in our laboratory. Both patients were DPD deficient upon evaluation for toxicity. Capecitabine can lead to severe and sometimes life-threatening toxicities akin to toxicities caused by 5-FU in patients with DPD deficiency. In cases of unexpected severe toxicity during capecitabine treatment, DPD deficiency should be considered. We suggest that capecitabine should not be used in patients with DPD deficiency. Screening should be considered in view of the widespread use of capecitabine and 5-FU, the severe toxicity that can develop in patient with low DPD activity, and the prevalence of the mutation.

KW - 5-Fluorouracil

KW - Hand-foot syndrome

KW - Klebsiella bacteremia

KW - Toxicity

UR - http://www.scopus.com/inward/record.url?scp=33244477449&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33244477449&partnerID=8YFLogxK

U2 - 10.3816/CCC.2006.n.007

DO - 10.3816/CCC.2006.n.007

M3 - Article

C2 - 16512996

AN - SCOPUS:33244477449

VL - 5

SP - 359

EP - 362

JO - Clinical Colorectal Cancer

JF - Clinical Colorectal Cancer

SN - 1533-0028

IS - 5

ER -