OBJECTIVES:

Genetic polymorphisms in dihydropyrimidine dehydrogenase gene (DPYD) have been associated with severe toxicity related to treatment with fluorpiridins. The aim of this work was to evaluate the cost-effectiveness of the screening of three mutations in the DPYD gene.

METHODS:

A three-month study was carry out. Colorectal cancer patients treated with fluorpiridines were included. Clinical data of the patients were obtained from SAP® infomatic application. Toxicities were studied in the first and second chemotherapy cycles.

Analysis was done comparing the cost of screening of DPYDg polymorphisms, and the costs, as hospitalization days, derived from severe toxicity fluoropyrimidine-induced in included patients. Only direct cost of reactives and hospital admissions days (434,63€/day, according to 2016 BOC) were included for the analysis.

Genomic DNA was obtained from a peripheral blood sample using the alcaline lysis method. Genetic characterization was carried out using LightClycler®480 platform and specific allele HybProbe fluorescent probes. Polymorphisms analyzed were: rs3918290(DPYD*2A), rs67376798(DPYD 2846A>T) and rs55886062(1679T>G, DPYD*13).

Patients were requested to sign an informed consent form prior to the inclusion.

RESULTS: The estimated cost for DNA extraction was 0.52€ per sample including reagents and plasticware. And the genetics caracterization was 6,8€/sample. So the total cost for the all patients genetic characterization was 263.52€.

CONCLUSIONS:

Our data suggest that the DPYD genotyping, using our fluorescent probes HybProbe®, is cost effective in fluoropyrimidine-based treatments. So, implementation of pharmacogenetics test in clinical practice will not only reduce severe toxicities of these treatments, will also save costs.