Pharmacogenetics of anti-cancer drugs: State of the art and implementation - recommendations of the French National Network of Pharmacogenetics

Therapie. 2017 Apr;72(2):205-215. doi: 10.1016/j.therap.2017.01.005. Epub 2017 Jan 30.


Individualized treatment is of special importance in oncology because the drugs used for chemotherapy have a very narrow therapeutic index. Pharmacogenetics may contribute substantially to clinical routine for optimizing cancer treatment to limit toxic effects while maintaining efficacy. This review presents the usefulness of pharmacogenetic tests for some key applications: dihydropyrimidine dehydrogenase (DPYD) genotyping for fluoropyrimidine (5-fluorouracil, capecitabine), UDP glucuronosylstransferase (UGT1A1) for irinotecan and thiopurine S-methyltransferase (TPMT) for thiopurine drugs. Depending on the level of evidence, the French National Network of Pharmacogenetics (RNPGx) has issued three levels of recommendations for these pharmacogenetic tests: essential, advisable, and potentially useful. Other applications, for which the level of evidence is still discussed, will be evoked in the final section of this review.

Keywords: Cancer; DPD; Oncology; Pharmacogenetics; TPMT; UGT1A1.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Antineoplastic Agents / pharmacokinetics*
  • Dihydrouracil Dehydrogenase (NADP) / genetics*
  • Genotyping Techniques
  • Glucuronosyltransferase / genetics*
  • Humans
  • Methyltransferases / genetics*
  • Pharmacogenetics*
  • Pharmacogenomic Testing
  • Polymorphism, Genetic*


  • Antineoplastic Agents
  • Dihydrouracil Dehydrogenase (NADP)
  • Methyltransferases
  • thiopurine methyltransferase
  • UGT1A1 enzyme
  • Glucuronosyltransferase