NCCN Updates Colon Cancer Guidelines, Recommends DPYD Testing Before Fluoropyrimidine Chemotherapy

The National Comprehensive Cancer Network (NCCN) recently updated its guidelines for colon cancer treatment, now recommending testing for variants in the dihydropyrimidine dehydrogenase (DPYD) gene before beginning chemotherapy regimens that include fluoropyrimidines. This update aims to improve patient safety and personalize treatment approaches for individuals with colon cancer. Specifically, the updated NCCN guidelines address the potential for severe toxicity associated with fluoropyrimidine-based chemotherapy, such as 5-fluorouracil (5-FU) and capecitabine. Variations in the DPYD gene can affect how the body metabolizes these drugs, and individuals with certain DPYD variants are at a significantly higher risk of experiencing severe and potentially life-threatening side effects. By recommending pre-treatment testing for DPYD variants, the NCCN seeks to identify patients who may require alternative dosing strategies or alternative chemotherapy agents altogether, ultimately striving to minimize adverse events and optimize treatment outcomes.

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Date: April 25, 2025

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Author

Mark Chiang