We read a very interesting article by Hulshof EC et al. in which they studied the role of UGT1A1 genotype guidance in irinotecan administration
[
[1]
]. Although the association of UGT1A1 polymorphisms with irinotecan-related toxicity
is well established [
2
,
3
,
- Mhandire D.Z.
- Goey A.K.L.
The value of pharmacogenetics to reduce drug-related toxicity in cancer patients.
Mol Diagn Ther. 2022; https://doi.org/10.1007/s40291-021-00575-x
4
], there is insufficient evidence for the effect of genotype-guided dose adjustment
on clinical outcomes, so genetic testing is not yet routinely performed before starting
irinotecan therapy currently [
- Karas S.
- Innocenti F.
All you need to know about UGT1A1 genetic testing for patients treated with irinotecan:
a practitioner-friendly guide.
JCO Oncol Pract. 2021; (OP2100624)https://doi.org/10.1200/op.21.00624
2
,
3
,
- Mhandire D.Z.
- Goey A.K.L.
The value of pharmacogenetics to reduce drug-related toxicity in cancer patients.
Mol Diagn Ther. 2022; https://doi.org/10.1007/s40291-021-00575-x
4
].- Karas S.
- Innocenti F.
All you need to know about UGT1A1 genetic testing for patients treated with irinotecan:
a practitioner-friendly guide.
JCO Oncol Pract. 2021; (OP2100624)https://doi.org/10.1200/op.21.00624
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References
- UGT1A1 genotype-guided dosing of irinotecan: a prospective safety and cost analysis in poor metaboliser patients.Eur J Cancer. 2022; 162: 148-157https://doi.org/10.1016/j.ejca.2021.12.009
- Pre-therapeutic UGT1A1 genotyping to reduce the risk of irinotecan-induced severe toxicity: ready for prime time.Eur J Cancer. 2020; 141: 9-20https://doi.org/10.1016/j.ejca.2020.09. 007
- The value of pharmacogenetics to reduce drug-related toxicity in cancer patients.Mol Diagn Ther. 2022; https://doi.org/10.1007/s40291-021-00575-x
- All you need to know about UGT1A1 genetic testing for patients treated with irinotecan: a practitioner-friendly guide.JCO Oncol Pract. 2021; (OP2100624)https://doi.org/10.1200/op.21.00624
- Irinotecan-induced toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.Pharmacogenomics J. 2017; 17: 21-28https://doi.org/10.1038/tpj.2016.58
- FOLFIRI (folinic acid, fluorouracil, and irinotecan) increases not efficacy but toxicity compared with single-agent irinotecan as a second-line treatment in metastatic colorectal cancer patients: a randomized clinical trial.Ther Adv Med Oncol. 2022; 14 (17588359211068737)https://doi.org/10.1177/17588359211068737
- Impact of UGT1A1 genotype on the efficacy and safety of irinotecan-based chemotherapy in metastatic colorectal cancer.Cancer Sci. 2021; 112: 4669-4678https://doi.org/10.1111/cas.15092
- Individualization of irinotecan treatment: a review of pharmacokinetics, pharmacodynamics, and pharmacogenetics.Clin Pharmacokinet. 2018; 57: 1229-1254https://doi.org/10.1007/s40262-018-0644-7
Article info
Publication history
Published online: May 31, 2022
Accepted:
March 1,
2022
Received:
February 17,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- UGT1A1 genotype-guided dosing of irinotecan: A prospective safety and cost analysis in poor metaboliser patientsEuropean Journal of CancerVol. 162Open Access
- Response to letter entitled re: UGT1A1 genotype-guided dosing of irinotecan: A prospective safety and cost analysis in poor metaboliser patients: Is it time for everyone treated with irinotecan to be tested for UGT1A1 gene polymorphism?European Journal of CancerVol. 172
- PreviewWe would like to thank Dr. Kong and colleagues for their letter in support of the importance of UGT1A1 genotype-guided dosing of irinotecan. Our recently published study showed that UGT1A1 genotype-guided dosing of irinotecan strongly decreased the incidence of severe adverse events, provided therapeutic systemic drug exposure, and was also cost-saving [1]. We fully agree with the recommendation of Kong et al. that UGT1A1 genotype testing to be incorporated in clinical treatment guidelines as an essential test to be carried out before the start of therapy.
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