TEST:

DPYD Test

We propose that DPYD testing should be evaluated through a globally transferable framework incorporating ancestry-aware variant coverage, rapid turnaround pathways, genotype-linked dose decision support, budget-impact assessment and real-world toxicity surveillance. Such an approach may help translate cost-effective pharmacogenomics into equitable, operationally feasible breast cancer care across diverse health systems.

This commentary on a cohort study of patients with uncommon DPYD variants resulting in increased toxicities highlights the importance of expanding the current DPYD testing profile, the limitations of current testing, and the critical need to consider patients of African ancestry who can carry rare yet extremely toxic DPYD variants.

Existing literature demonstrates the benefits of DPYD and UGT1A1 pharmacogenetic (PGx) testing to reduce toxicity from fluoropyrimidines and irinotecan, respectively...PGx testing was underutilized for supportive care medications despite its relevance, but there is an opportunity to leverage panel-based approaches to increase utilization without additional workflow burden. Description of these key considerations and takeaways reported by those implementing DPYD and/or UGT1A1 PGx testing would be beneficial to institutions in the early phases of implementation.

''Labcorp...today announced the availability of its expanded DPYD Genotyping testopens in a new tab to help identify cancer patients who may be at increased risk for severe or life-threatening side effects from fluoropyrimidine chemotherapy. Labcorp now offers genotype testing for all DPYD Tier 1 and Tier 2 variants recommended by the Association for Molecular Pathologyopens in a new tab (AMP).''