Toxicities associated with chemotherapy regimens containing a fluoropyrimidine: A real-life evaluation in France - Individual Prediction and Prevention of Risks of Immunosuppressive Therapies in Transplantation Access content directly
Journal Articles European Journal of Cancer Year : 2020

Toxicities associated with chemotherapy regimens containing a fluoropyrimidine: A real-life evaluation in France

Abstract

AIMS: Despite fluoropyrimidines (FPs) constituting the main component of the chemotherapy combination protocols in 50% of chemotherapies for solid tumour treatments, incidence data for FP-related toxicity are poorly documented in real life. This study evaluated the number of patients receiving FP-based chemotherapies in France, along with the true incidence of FP-related serious adverse effects (SAEs) before the recent mandatory dihydropyrimidine dehydrogenase (DPD)-screening was introduced by French health authorities, DPD being the rate-limiting enzyme of 5-fluorouracil (5-FU) catabolism.METHODS: Exhaustive data on the number of patients treated with FP-based chemotherapy in 2013-2014 were collected in the Centre-Val de Loire region of France. True incidence of SAEs was extracted from a cohort of 513 patients with incident solid tumours receiving first-line FP-based chemotherapy.RESULTS: After extrapolation at national level, we estimated that 76,200 patients are currently treated annually with 5FU (53,100 patients, 62% digestive system-related versus 26% breast cancers versus 12% head and neck cancers) or capecitabine (23,100 patients, 45% digestive system-related versus 37% breast cancers versus 18% non-documented). Earlier (in the first two cycles) the SAE incidence rate was 19.3% (95% confidence interval (CI) 16-23%) including one toxic death (0.2%, 95%CI 0-1%). SAE incidence rate was 32.2% (95%CI 28-36%) over the first 6 months of treatment. Incidence of death, life-threatening prognosis or incapacity/disability was 1.4% (95%CI 0.4-2.4%) and 1.6% (95%CI 0.5-2.6%) during first two cycles and first 6 months, respectively.CONCLUSION: These data highlight the significant public health issue related to FP toxicity, with around 1200 patients developing FP-related life-threatening prognosis or incapacity/disability annually in France, including 150 toxic deaths. It is hoped that DPD-deficiency screening will reduce such iatrogenic events and eradicate toxic deaths.
Fichier principal
Vignette du fichier
S0959804919307567.pdf (2.63 Mo) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-02497276 , version 1 (20-07-2022)

Licence

Attribution - NonCommercial

Identifiers

Cite

Chantal Barin-Le Guellec, Claire Lafay-Chebassier, Isabelle Ingrand, J. F. Tournamille, A. Boudet, et al.. Toxicities associated with chemotherapy regimens containing a fluoropyrimidine: A real-life evaluation in France. European Journal of Cancer, 2020, 124, pp.37-46. ⟨10.1016/j.ejca.2019.09.028⟩. ⟨hal-02497276⟩
83 View
71 Download

Altmetric

Share

Gmail Facebook X LinkedIn More