Today sees the publication of the 4th UK CERSI-PGx guideline on the use of UGT1A1 genotype testing to support the safe prescribing of irinotecan.
Irinotecan is an important medicine used to treat different forms of cancer. A simple genetic test can show whether a patient with an epithelial cancer such as bowel cancer can take the standard dose safely. If not, the dose can be reduced. This approach helps make treatment more personal, lowers the risk of harmful side effects and potentially will also reduce unnecessary interruptions or stopping of treatment.
A sincere thank you to Dharmisha Chauhan for her excellent work Chairing the group on the development of the guideline, and to all the experts who contributed to this work. We are also grateful to the external stakeholders who provided valuable comments during the consultation process. as well as to the members of the PPIE group for preparing the plain English summary.
Indication for UGT1A1 testing:
Epithelial cancers: UGT1A1 testing should be offered to all patients who are due to receive irinotecan-based regimens, irrespective of their ancestry.
Non-epithelial cancers: There is inadequate evidence to recommend the routine pre-prescription use of UGT1A1 genotyping in patients receiving irinotecan for non-epithelial malignancies, where daily day doses are usually lower than in epithelial cancers. Where higher doses of irinotecan are used, for example, for the treatment of glioblastoma multiforme, the use of genotyping is optional and further evidence is required in this patient group.
History of severe toxicity: Genotyping should be considered in patients of any age with any malignancy where severe toxicity (Grade 3 or higher) has been seen with the use of irinotecan, irrespective of dose.
Full text available at the British Journal of Pharmacology: http://doi.org/10.1002/bcp.70659