- Title
- Evaluation of early fluoropyrimidine toxicity in solid organ cancer patients: a retrospective observational study in Australia
- Creator
- White, Cassandra; Kendall, Guy; Millington, Tegan; Corcoran, Bern; Paul, Christine; Scott, Rodney J.; Ackland, Stephen
- Relation
- Internal Medicine Journal Vol. 54, Issue 9, p. 1506-1514
- Publisher Link
- http://dx.doi.org/10.1111/imj.16463
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Despite common global usage, fluoropyrimidine (FP; 5-flurouracil and capecitabine)-related chemotherapy toxicity is poorly reported in the literature, with serious toxicity ranging from 10% to 40% and early toxicity (within 60 days of exposure) quoted at 14%. Data reflecting the incidence of Grades 3–5 FP-related toxicity in Australian cancer patients is scant, despite the significant impact of toxicity on patients (hospitalisations, intensive care unit (ICU) admissions and even death). Aims: This retrospective audit evaluated Grades 3–5 toxicities in a contemporaneous cohort of 500 patients receiving FP chemotherapies within the Hunter-New England Local Health District from June 2020 to June 2022. Data were extracted from public hospital records and oncology-specific e-records to determine rates of toxicity and associated hospitalisations, intensive care admissions and deaths that occurred within 60 days of first exposure to FP chemotherapy-containing regimens. Results: One hundred and fifty incidents of Grades 3–4 toxicity in the first 60 days led to 87 patients presenting to hospital (87/500, 17.4%). The most common serious toxicities were diarrhoea (39.3%), nausea and vomiting (22.7%) and febrile neutropaenia (10%). Four patients were admitted to the ICU, and four patients died of toxicity. Within the first 60 days, 22.2% of patients required treatment delays, 21.4% required dose reductions, and 7.8% of patients ceased treatment because of toxicities. Discussion and Conclusion: Our experience reflects international reports and is likely generalisable to the Australian population. These data are a basis to understand the potential benefits of precision medicine strategies such as pharmacogenomic screening to improve patient tolerability and the cost-effectiveness of FP chemotherapy prescribing.
- Subject
- fluoropyrimidine; chemotherapy; cancer; toxicity; DPYD genotyping; pharmacogenomics; SDG 3; Sustainable Development Goal
- Identifier
- http://hdl.handle.net/1959.13/1511739
- Identifier
- uon:56540
- Identifier
- ISSN:1444-0903
- Language
- eng
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