Krishnan A. Optimizing fluoropyrimidine therapy through dihydropyrimidine dehydrogenase polymorphism testing. World J Gastrointest Oncol 2025; 17(5): 101320 [PMID: 40487937 DOI: 10.4251/wjgo.v17.i5.101320]
Corresponding Author of This Article
Arunkumar Krishnan, MD, MS, Assistant Professor, Research Scientist, Department of Supportive Oncology, Atrium Health Levine Cancer, 1021 Morehead Medical Drive, Suite 70100, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2025; 17(5): 101320 Published online May 15, 2025. doi: 10.4251/wjgo.v17.i5.101320
Optimizing fluoropyrimidine therapy through dihydropyrimidine dehydrogenase polymorphism testing
Arunkumar Krishnan
Arunkumar Krishnan, Department of Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC 28204, United States
Author contributions: Krishnan A contributed to the concept of the study, drafted the manuscript, and performed the review and editing. The manuscript was critically revised for important intellectual content and finalized by Krishnan A.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Arunkumar Krishnan, MD, MS, Assistant Professor, Research Scientist, Department of Supportive Oncology, Atrium Health Levine Cancer, 1021 Morehead Medical Drive, Suite 70100, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Received: September 10, 2024 Revised: January 22, 2025 Accepted: February 10, 2025 Published online: May 15, 2025 Processing time: 246 Days and 16.5 Hours
Core Tip
Core Tip: Dihydropyrimidine dehydrogenase (DPYD) polymorphism testing is important for minimizing severe fluoropyrimidine (FP)-related toxicities in cancer patients. This pharmacogenetic strategy promotes personalized dosing, improving patient safety and tolerability. A study by D’Amato et al assessed the prevalence of DPYD polymorphisms and their impact on FP tolerability in patients with gastrointestinal malignancies. However, it is important to tackle study limitations such as retrospective designs, variability in testing, and confounding factors and assess the cost-effectiveness of including DPYD testing in standard clinical practice. Future studies should broaden genetic screening, provide pre-treatment counseling, and establish standardized methodologies to improve clinical relevance.
