Dihydropyrimidine dehydrogenase deficiency

And I think in a previous podcast episode, we talked about earlier testing for PIK3.

I think inevitably a lot of those patients are going to be profiled for DPYD.

So you might have kind of a double benefit in that sense for this population as well.

Exactly.

What questions would you want them to ask their treating oncologists in order to get tested?

The simple thing to ask is, you know, what drugs are you recommending for me? The specific question is if the treatment is going to include either 5-FU, which is an abbreviation for 5-fluoruracil, or if it's going to include capecitabine, do I need to be tested for DPD deficiency or do I need to have a DPYD gene test? The answer should be yes.

I have a very cool guest who has been on this podcast before, but many, many years ago.

And it's one of those episodes that I distinctly remember because I walked away having actually understood the incentives around our healthcare system.

And it's just, well, what...

the level of the dose that is unsafe differs depending on whether or not you have one of these abnormal gene variants.

The treatment for abnormal, and the condition is called DPD deficiency, because DPD is the abbreviation for the enzyme dihydropyrrimidine dehydrogenase.

So DPD deficiency, the treatment for that is to figure out what is the degree of the deficiency and then to adjust the dose accordingly.