Policy Brief - Testeo genético de DPYD precio a fluoropirimidinas en cánceres sólidos: una política sanitaria para reducir la toxicidad grave en oncología

12 response to 5-fluorouracil-based treatment in Chilean patients with advanced colorectal cancer. Frontiers in Oncology, 15, 1589724. https://doi.org/10.3389/ fonc.2025.1589724 Chan, T. H., Zhang, J. E., & Pirmohamed, M. (2024). DPYD genetic polymorphisms in non-European patients with severe fluoropyrimidine-related toxicity: A systematic review. British Journal of Cancer, 131(3), 498–514. https://doi.org/10.1038/s41416-024-02754-z Córdova-Delgado, M., Bravo, M. L., Cumsille, E., Hill, C. N., Muñoz-Medel,M.,Pinto,M.P.,Retamal, I.N., Lavanderos, M. A., Miquel, J. F., Rodriguez-Fernandez, M., Liao, Y., Li, Z., Corvalán, A. H., Armisén, R., Garrido, M., Quiñones, L. A., & Owen, G. I. (2021). A case-control study of a combination of single nucleotide polymorphisms and clinical parameters to predict clinically relevant toxicity associated with fluoropyrimidine and platinum-based chemotherapy in gastric cancer. BMC Cancer, 21 , 1030. https://doi.org/10.1186/s12885-021-08745-0 Donadio, M. D. S., Carraro, D. M., Torrezan, G. T., & de Mello, C. A. L. (2022). Dihydropyrimidine dehydrogenase (DPD) polymorphisms knocking on the door. ecancermedicalscience, 16, 1344. https://doi. org/10.3332/ecancer.2022.1344 European Medicines Agency (EMA). (2020). EMA recommendations on DPD testing prior to treatment with fluorouracil, capecitabine, tegafur and flucytosine . https://www.ema.europa.eu Farinango, C., Gallardo-Cóndor, J., Freire-Paspuel, B., Flores- Espinoza, R., Jaramillo-Koupermann, G., López-Cortés, A., Burgos, G., Tejera, E., & Cabrera-Andrade, A. (2022). Genetic variations of the DPYD gene and its relationship with ancestry proportions in different Ecuadorian trihybrid populations. Journal of PersonalizedMedicine, 12 (6), 950. https://doi.org/10.3390/jpm12060950 Food and Drug Administration (FDA). (2025). Safety labeling update for capecitabine and fluorouracil on risks associated with dihydropyrimidine dehydrogenase deficiency. U.S. Food and Drug Administration. https://doi. org/10.3389/fonc.2025.1589724 Glewis, S., Fagery, M., Lingaratnam, S., Harris, S., Georgiou, C., Underhill, C., Warren, M., Campbell, R., Martin, J. 5. MATERIAL DE CONSULTA Y REFERENCIAS Amstutz, U., Henricks, L. M., Offer, S. M., Barbarino, J., Schellens, J. H. M., Swen, J. J., Klein, T. E., McLeod, H. L., Caudle, K. E., Diasio, R. B., & Schwab, M. (2018). Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing: 2017 update. Clinical Pharmacology & Therapeutics , 103(2), 210– 216. https://doi.org/10.1002/cpt.911 Arancel FONASA. (2025). Normas generales y valores 2025. Diario Oficial. Baker, S. D., Bates, S. E., Brooks, G. A., Dahut, W. L., Diasio, R. B., El-Deiry, W. S., Evans, W. E., Figg, W. D., Hertz, D. L., Hicks, J. K., Kasi, P. M., Knepper, T. C., McLeod, H. L., O’Donnell, P. H., Relling, M. V., Rudek, M. A., Sissung, T. M., Smith, D. M., Sparreboom, A., Swain, S. M., & Walko, C. M. (2023). DPYD testing: Time to put patient safety first. Journal of Clinical Oncology, 41(15), 2701– 2705. https://doi.org/10.1200/JCO.22.02364 Brooks, G. A., Tapp, S., Daly, A. T., Busam, J. A., &Tosteson, A. N. A. (2022). Cost-effectiveness of DPYD genotyping prior to fluoropyrimidine-based adjuvant chemotherapy for colon cancer. Clinical Colorectal Cancer, 21(3), e189– e195. https://doi.org/10.1016/j.clcc.2022.05.001 Cayún, J. P., Cerpa, L. C., Colombo, A., Cáceres, D. D., Leal, J. L., Reyes, F., Gutiérrez-Cáceres, C., Calfunao, S., Varela, N. M., & Quiñones, L. A. (2024). Genetic polymorphisms and tumoral mutational profiles over survival in advanced colorectal cancer patients: An exploratory study. Current Oncology, 31(1), 274–295. https://doi.org/10.3390/curroncol31010018 CDA-AMC, Canada’s Drug Agency. (2025). Dihydropyrimidine dehydrogenase deficiency testing for patients treated with fluorouracil and capecitabine. ht tps : / /www. cda-amc . ca/d i hydropy r imi d i ne- dehydrogenase-deficiency-testing-patients-treated-5- fluorouracil-and-capecitabine Cerpa, L. C., Sandoval, C., Escalante, P., Cayún, J. P., Lavanderos, M. A., Alarcón-Concha, C., Kaempfe, G., Moreno-Tapia, D., Quiroz, C. S., Gutierrez-Cáceres, C., Barajas, O., Müller, B., Colombo, A., Donoso, G., Nuñez, A., Varela, N. M., & Quiñones, L. A. (2025). Genetic variants and clinical determinants affecting the