High uracil levels may predict fluoropyrimidine-related toxicity
medwireNews: Researchers say that measuring patients’ uracil levels prior to fluoropyrimidine therapy could help identify those who might benefit from dose alteration to reduce their risk for severe and fatal side effects.
Didier Meulendijks, from The Netherlands Cancer Institute in Amsterdam, and co-workers looked at the dihydropyrimidine dehydrogenase (DPD) substrate uracil as an alternative to the “technically and logistically challenging, laborious, and expensive” process of measuring DPD itself.
Among 550 fluoropyrimidine-treated patients drawn from a previous multicenter trial (NCT00838370), baseline serum uracil concentrations above 16 ng/mL versus below 13 ng/mL were significantly associated with an increased risk for severe global and gastrointestinal toxicity, hospitalization, and fatal treatment-related toxicity, with respective odds ratios of 5.3, 33.7, 16.9, and 44.8.
By contrast, high uracil levels did not predict the occurrence of severe hematological side effects.
Based on their findings, which appear in the British Journal of Cancer, the study authors believe that prescreening “could be an effective approach to improve patient safety.”
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