Pharmacogenetic Testing for Cancer Treatment Safety

Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Michigan Rogel Cancer Center
Must be taking: Fluoropyrimidine, Irinotecan
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how genes impact the safety and effectiveness of cancer treatments with Fluoropyrimidine or Irinotecan. Researchers aim to understand how certain genetic traits might affect treatment outcomes, such as side effects or the need for dose changes. The trial involves two groups: those with known genetic traits and those without this genetic information. It suits individuals with cancer who are starting or have already started treatment with these drugs, especially if genetic testing has identified specific traits linked to treatment response, such as DPYD or UGT1A1 variants.

As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to important findings.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, it focuses on starting treatment with specific cancer drugs, so it's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that testing for specific genetic markers, DPYD and UGT1A1, before treatment can enhance patient safety. These tests enable doctors to adjust doses of chemotherapy drugs like fluoropyrimidine and irinotecan. Studies indicate that using these tests to guide treatment reduces drug side effects for patients.

Testing before chemotherapy, for example, has been proven to lessen side effects without compromising treatment effectiveness. This approach allows patients to receive effective cancer care more safely. Additionally, real-world evidence supports that these tests significantly improve patient safety.

In summary, genetic testing to guide chemotherapy dosing offers a promising way to make cancer treatment safer.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it uses pharmacogenetic testing to tailor cancer treatments based on individual genetic variants, specifically DPYD and UGT1A1. Unlike standard chemotherapy, which is often a one-size-fits-all approach, this method personalizes treatment plans, potentially reducing harmful side effects and improving effectiveness. By identifying genetic variants that affect drug metabolism, clinicians can adjust dosages or select alternative therapies, making cancer treatment safer and more effective for each patient. This personalized approach marks a significant advancement in precision medicine, aiming to optimize therapeutic outcomes while minimizing risks.

What evidence suggests that this trial's treatments could be effective for cancer treatment safety?

Research shows that testing for certain genetic differences, called DPYD and UGT1A1 variants, can make chemotherapy treatments safer. This trial includes two arms: the "Cases" arm, where participants undergo confirmatory genetic testing to guide chemotherapy treatment, and the "Controls" arm, consisting of patients who receive treatment without prior genetic information. Studies have found that genetic testing helps adjust the chemotherapy dose, reducing side effects by half for patients with gastrointestinal (GI) cancers. Specifically, changes in the DPYD gene link to severe side effects from fluoropyrimidine, a common chemotherapy drug. Adjusting doses based on these genetic tests improves safety without reducing treatment effectiveness. This personalized approach ensures patients receive the most effective dose while minimizing harm.36789

Who Is on the Research Team?

AP

Amy Pasternak

Principal Investigator

University of Michigan Rogel Cancer Center

Are You a Good Fit for This Trial?

This trial is for adults with cancer who may have genetic variants (DPYD or UGT1A1) that could affect how they respond to chemotherapy drugs like Fluoropyrimidine or Irinotecan. Participants must understand and consent to the study. Those previously treated with these drugs, unable to consent, or with a history of certain transplants are excluded.

Inclusion Criteria

I am older than 18 years.
My medication dose was reduced based on genetic test results.
I have a specific genetic marker related to how my body processes certain cancer drugs.
See 3 more

Exclusion Criteria

I have had a liver transplant.
I have been treated with FP due to a suspected DPYD gene issue.
I have been treated with irinotecan due to my specific genetic makeup.
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Standard of care treatment initiated with either Fluoropyrimidine or Irinotecan therapy

5 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • DPYD or UGT1A1 variants
Trial Overview The study tests if patients' genetic makeup (specifically DPYD or UGT1A1 variants) influences side effects when treated with Fluoropyrimidine or Irinotecan. It involves looking back at past treatments and outcomes as well as monitoring new patients starting therapy.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: ControlsExperimental Treatment0 Interventions
Group II: CasesExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Michigan Rogel Cancer Center

Lead Sponsor

Trials
303
Recruited
20,700+

Citations

Implementation of DPYD and UGT1A1 Testing in Patients With ...DPYD/UGT1A1 testing is an important precision oncology approach to optimize patient safety.
Genetic testing lowers risks from chemo for GI cancerGenetic testing for certain variants in GI cancer patients cuts chemotherapy side effects in half by tailoring doses.
Real‐world study on fluoropyrimidine‐related toxicity ...DPYD gene variations are associated with severe fluoropyrimidine toxicity, and an initial 50% dose reduction is widely recommended for heterozygous carriers ...
Clinical Benefits and Utility of Pretherapeutic DPYD and ...In this trial, pharmacogenetic-informed prescribing increased safety and did not appear to compromise efficacy in patients with gastrointestinal cancer.
Clinical implementation and outcome evaluation of ...Evidence showed that safety is increased when upfront testing of DPYD is followed by dose adjustment in carriers of clinically actionable variants. The cost- ...
DPYD and UGT1A1 Pharmacogenetic Testing in Patients ...In this review, the PGx profiles of drug-gene pairs with potential impact in GI malignancy therapy – DPYD-5-fluorouracil/capecitabine and UGT1A1-irinotecan –
Implementation of DPYD and UGT1A1 Testing in Patients ...Implementing pretreatment DPYD/UGT1A1 testing and genotype-guided dose reductions can reduce TRAEs in patients with pharmacogenomic variants.
Real‐world implementation of DPYD and UGT1A1 ...Pre-chemotherapy pharmacogenetic testing for DPYD and UGT1A1 has also been documented to significantly improve patient safety, for patients ...
Pharmacogenetic Testing 2025-11-15The NCCN issued updated guidance in 2025 stating “Testing for DPYD genetic variants should be considered prior to fluoropyrimidine therapy. After discussions ...
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