Importance of and Strategies for Implementing DPYD Testing to Prevent Severe Fluoropyrimidine Chemotherapy Toxicity in Health Care Systems

Review of DPYD testing implementation following FDA boxed warnings (capecitabine/5-FU 2025), ASCO/NCCN alignment, practical deployment strategies in healthcare systems

Following the 2025 FDA boxed warning addition to capecitabine and 5-fluorouracil labels recommending pre-therapeutic DPYD testing, the American Society of Clinical Oncology publishes a practical review of institutional implementation strategies. This update aligns US practice with European recommendations (EMA) and synthesizes organizational approaches for integrating DPYD testing into oncology workflows, including pre-ordering models, turnaround times, and management of variants of uncertain significance.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

The 2025 FDA alert marks a decisive turning point for DPYD testing adoption in the United States, long behind Europe. This ASCO review translates recommendations into concrete operational strategies, essential for teams that must now deploy DPYD testing at scale in their institutions. Worth monitoring for upcoming CPIC/NCCN guideline updates.

Clinical impact: 3/3 · Evidence strength: 3/3 · Novelty: 1/2 · Sample size: 1/1 · Publication status: 1/1 → Total: 9/10