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Velindre Cancer Centre in fluorouracil based chemotherapy genetic screening first
Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board Bwrdd Iechyd Prifysgol Hywel Dda University Health Board
Bwrdd Iechyd Addysgu Powys Powys Teaching Health Board
Iechyd Cyhoeddus Velindre Cancer Centre in fluorouracil based Cymru Public Health Wales chemotherapy genetic screening first
Ymddiriedolaeth GIG Prifysgol Felindre Velindre University NHS Trust
Ymddiriedolaeth GIG Gwasanaethau Ambiwlans CymruVelindre Cancer Centre are delighted to become the first in the UK to Welsh Ambulance Services NHS Trust routinely provide all cancer patients being treated with fluorouracil based chemotherapy genetic screening to identify their risk of severe side-effects and help prevent this occurring. This has been done through implementing a new way of DPYD gene testing which launched in May 2020. DPYD gene testing is used to determine whether a patient has one of five known genetic variants which result in either an absence of or reduced levels of DPD. It is performed using a blood test which is processed at the All Wales Genomics Laboratory. If a variant is identified, clinical guidance is to dose reduce or avoid fluorouracil based drugs to minimise the risk of severe sideeffects thus improving patient safety. Working closely with the AWMGS, VCC has developed processes and systems to ensure that DPYD genetic test results are available prior to the patient’s treatment start to ensure safe treatment doses right from cycle 1. Since the launch, the team have now identified its 100th patient who has tested positive for DPD variants, and so whom have had their chemotherapy dosages safely amended accordingly. Speaking of the DPD Testing, Sian M Morgan FRCPath, Consultant Clinical Scientist / Head of Laboratory, All Wales Medical Genetics Service, All Wales Genomics Laboratory said “What an achievement! Our collaboration to pilot DPYD gene testing, which commenced early in 2020, led to all Health Boards across Wales routinely offering the test by autumn 2020. It is motivating to see Wales once again leading the way to improve patient care.’’ Samantha Jane Cox, Consultant Clinical Oncologist at Velindre Cancer Centre told us “It was more important than ever to ensure this screening was launched during the pandemic as unidentified DPDdeficient patients may develop significant side-effects requiring hospital admission at either VCC or neighbouring Health Boards during the COVID-19 outbreak which may increase their risk of exposure to the virus. Unidentified DPD-deficient patients with severe toxicity may also require hospital admission at a time when bed capacity at VCC and neighbouring Health Boards is likely to be reduced during the COVID-19 outbreak. Establishing a project board with multidisciplinary clinical input and experienced project support was key to the success of this project, especially during the challenges of the COVID pandemic. This is a model that should be available for future genomics service developments.’’
“What an achievement! Our collaboration to pilot DPYD gene testing, which commenced early in 2020, led to all Health Boards across Wales routinely offering the test by autumn 2020. It is motivating to see Wales once again leading the way to improve patient care.’’ Sian M Morgan
FRCPath, Consultant Clinical Scientist Head of Laboratory All Wales Medical Genetics Service All Wales Genomics Laboratory
