Fluoropyrimidines such as 5-fluorouracil (5-FU) and capecitabine remain cornerstone chemotherapies in oncology. However, for patients with certain DPYD gene variants, these commonly used drugs can cause life-threatening toxicities due to impaired metabolism of the active compounds.


In this episode of the Precision Medicine Pharmacist Podcast, host Melissa Smith, PharmD, explores how DPYD genotyping is transforming oncology care by helping clinicians identify patients at risk before toxicity occurs. Joined by Karen Merritt, an advocate for universal DPD testing and leader with the Test4DPD initiative, the discussion sheds light on how pharmacogenomics is shaping safer, more personalized cancer treatment.




Together, they explore current evidence, new FDA updates, and implementation frameworks that empower pharmacists and oncology teams to prevent preventable harm through precision medicine.


🧠 Key Discussion Topics

• The science behind DPYD gene variants and their clinical implications


• How undiagnosed DPD deficiency contributes to preventable toxicity


• New recommendations from the CPIC® Guideline for Fluoropyrimidines and DPYD


• Insights from the Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines


• Advocacy for universal DPYD testing across oncology centers


• How pharmacists can champion pharmacogenomic testing integration in oncology workflows


• Updates from the FDA-approved labeling for Xeloda (capecitabine)
  
  

🎧 Featured Guest
Karen Merritt

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Karen Merritt is a passionate advocate for pharmacogenomic testing and patient safety in oncology care. Through her leadership in the Test4DPD movement, she works to expand awareness and adoption of DPYD testing worldwide, ensuring patients are protected from severe chemotherapy-related toxicities.


📚 Resources & References

• Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines into Clinical Practice (PMC)


• CPIC® Guideline for Fluoropyrimidines and DPYD


• Advocates for Universal DPD/DPYD Testing – Test4DPD


• Updated FDA-Approved Label for Xeloda (Capecitabine)

 


💊 About the Show


The Precision Medicine Pharmacist Podcast explores the evolving role of pharmacists in precision health, pharmacogenomics, and individualized patient care. Each episode highlights clinical insights, implementation strategies, and inspiring stories from professionals leading the way in personalized medicine.