让患者有选择在用皮里米丁进行化疗之前进行DPD缺乏症测试
Ken Surprenant1, Lindsay Murray1, Karen Merritt1
1Ken Surprenant, MA, Advocates for Universal DPD/DPYD Testing, Battle Creek, MI; Lindsay Murray, HS, Advocates for Universal DPD/DPYD Testing, Andover, MA; Karen Merritt, BS, Advocates for Universal DPD/DPYD Testing, Chelan, WA; Maria Hopkins, BS, Advocates for Universal DPD/DPYD Testing, Battle Creek, MI; and Joanne McIntyre, AA, Advocates for Universal DPD/DPYD Testing, Portland, OR.
JCO oncology practice
|December 3, 2024
概括
在开始胺 (FU) 和胺 (Xeloda) 化疗之前,患者应确定DPYD查是否适合他们. 这种个性化的方法确保了有关化疗治疗基因检测的知情决策.
科学领域:
- 药物基因组学 药物基因组学
- 在瘤学瘤学.
- 临床决策 - 临床决策
背景情况:
- 甲胺 (例如,5-FU,capecitabine) 是广泛使用的化疗剂.
- DPYD酶活性会影响胺的代谢和毒性.
- DPYD遗传变异可以预测在接受胺剂的患者中发生的严重不良事件.
研究的目的:
- 评估在接受胺化疗的患者中对DPYD查的最佳策略.
- 强调患者在基因检测决策过程中的自主权.
主要方法:
- 审查目前关于DPYD查的指导方针和证据.
- 分析患者报告的基因检测结果和与基因检测相关的偏好.
- 讨论共享决策在瘤学中的作用.
主要成果:
- 建议在启动胺治疗之前对DPYD进行查.
- 患者的偏好和理解是决定DPYD查的关键因素.
- 医生主导的决策可能与个体患者的价值或风险承受能力不一致.
结论:
- 以患者为中心的决策应该指导DPYD查的实施.
- 赋予患者选择DPYD查的权力可以提高治疗的坚持和满意度.
- 将基因查整合到化疗决策中需要一种协作方法.
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