Abstract
Dihydropyrimidine dehydrogenase deficiency is diagnosed more frequently and is now generally accepted as a potentially life-threatening condition. It predisposes patients receiving treatment with fluoropyrimidines such as 5-fluorouracil (5-FU) to severe and, in case of complete dihydropyrimidine dehydrogenase deficiency, often fatal toxicity. A patient who had severe side effects following standard dose adjuvant 5-FU exposure was diagnosed of having hereditary partial dihydropyrimidine dehydrogenase deficiency. When the patient relapsed with liver metastases, we treated him with the non-fluoropyrimidine cytotoxic agents irinotecan, oxaliplatin and raltitrexed in sequential manner, and were able to show that these drugs can be safely applied in patients with this metabolic defect.
Publication types
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Case Reports
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Comparative Study
MeSH terms
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Adenocarcinoma / drug therapy*
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Adenocarcinoma / enzymology
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Adenocarcinoma / secondary
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Camptothecin / administration & dosage
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Camptothecin / analogs & derivatives
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Colorectal Neoplasms / drug therapy*
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Colorectal Neoplasms / enzymology
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Colorectal Neoplasms / pathology
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Dihydrouracil Dehydrogenase (NADP)
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Humans
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Irinotecan
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Liver Neoplasms / drug therapy*
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Liver Neoplasms / enzymology
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Liver Neoplasms / secondary
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Male
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Middle Aged
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Organoplatinum Compounds / administration & dosage
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Oxaliplatin
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Oxidoreductases / deficiency*
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Quinazolines / administration & dosage
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Thiophenes / administration & dosage
Substances
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Organoplatinum Compounds
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Quinazolines
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Thiophenes
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Oxaliplatin
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Irinotecan
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Oxidoreductases
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Dihydrouracil Dehydrogenase (NADP)
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raltitrexed
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Camptothecin