The Government of Saskatchewan, Saskatchewan Health Authority (SHA), and Saskatchewan Cancer Agency (SCA) are launching a genome testing program to improve the safety of patients receiving chemotherapy.Patients eligible for treatment with fluoropyrimidine-based drugs who may face severe or life-threatening side effects can now have in-province DPYD genotyping done before starting their treatment. This test identifies genetic variants in the DPYD gene, which affects the production of the DPD (dihydropyrimidine dehydrogenase) enzyme. "Screening for these genetic variants can help improve treatment outcomes for Saskatchewan cancer patients," Health Minister Everett Hindley said. "The introduction of DPYD genome testing shows our commitment to both precision medicine and patient safety. By making this a standard part of oncology practice, health-care providers can better manage treatment plans and potential complications."Previously, DPYD testing was done in the U.S. with a two-week turnaround time. Now, the Royal University Hospital Pharmacogenomic Lab in Saskatoon is offering the test locally, with results in 2 to 7 days. The lab expects to test around 1,000 patients annually."Conducting rapid testing for DPD enzyme deficiencies right here in Saskatchewan helps our teams provide safer and more effective care as quickly as possible for cancer patients across the province, by appropriately adjusting their care plans before they receive treatment," SHA Provincial Clinical and Support Services Vice President Bryan Witt said. "This is a positive step in continuing to explore innovative solutions that improve patient-centred outcomes and reaffirms our commitment to advancing personalized medicine.""Offering screening for DPD enzyme deficiency in Saskatchewan is one way we are ensuring cancer patients have access to the highest standard of care," Saskatchewan Cancer Agency Medical Services Vice-President Dr. Shazia Mahmood said. "Fluoropyrimidine based chemotherapy drugs are commonly used to treat multiple cancers, and DPD enzyme deficiency can lead to severe life-threatening toxicities in some patients. The Cancer Agency is pleased this testing will be offered to patients who are at risk in our ongoing efforts to ensure patient safety." Saskatchewan becomes the fourth province to implement DPYD testing.According to Australian health authorities, about 10-40% of patients treated with fluoropyrimidines (5-fluorouracil and capecitabine) develop severe adverse events such as myelosuppression, a bone marrow problem that can result in fewer white and red blood cells and fewer platelets.Other chemotherapy side effects include severe diarrhoea, stomatitis (inflamation of the mucous membrane of the mouth) and skin toxicity, including hand-foot syndrome, where redness, swelling and sometimes pain come to soles of the feet and palms of the hands.Fluoropyrimidines occasionally cause, life-threatening toxicities with treatment-related mortality rates of 0.2-1.0%.
