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Review
. 2021 Dec 9:14:1603-1617.
doi: 10.2147/PGPM.S337147. eCollection 2021.

Ethnic Diversity of DPD Activity and the DPYD Gene: Review of the Literature

Cassandra White  1   2 , Rodney J Scott  1   2   3 , Christine Paul  1   2 , Andrew Ziolkowski  3 , David Mossman  3 , Stephen Ackland  1   2   4
Affiliations
Review

Ethnic Diversity of DPD Activity and the DPYD Gene: Review of the Literature

Cassandra White et al. Pharmgenomics Pers Med. .

Abstract

Pharmacogenomic screening can identify patients with gene variants that predispose them to the development of severe toxicity from fluoropyrimidine (FP) chemotherapy. Deficiency of the critical metabolic enzyme dihydropyrimidine dehydrogenase (DPD) leads to excessive toxicity on exposure to fluoropyrimidine chemotherapy. This can result in hospitalisation, intensive care admissions and even death. Upfront screening of the gene that encodes for DPD (DPYD) has recently been implemented in regions throughout Europe and the United Kingdom. Current screening evaluates DPYD variants that are well described within Caucasian patient populations and provides genotyped-guided dose adjustment recommendations based upon the presence of these variants. This article reviews the differences in DPYD gene variants within non-Caucasian populations compared to Caucasian populations, with regard to the implications for clinical tolerance of fluoropyrimidine chemotherapies and genotype guided dose adjustment guidelines.

Keywords: DPYD gene; dihydropyrimidine dehydrogenase; non-Caucasian; pharmacogenomics.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Metabolic pathway of fluoropyrimidines.
Figure 2
Figure 2
Effect of DPD deficiency on 5-FU metabolites.
See this image and copyright information in PMC

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