Patients with cancer who are prescribed the drug irinotecan should have a DNA test before use.
This test can prevent serious side effects with hospitalizations.
This is shown by research by the Catharina Hospital that was recently published in the leading European Journal of Cancer.
There is a lot of national and international interest in the research. “Many hospitals also want to offer this test to their patients, because it can prevent a lot of suffering,” said hospital pharmacist and principal researcher Maarten Deenen from Someren.
About one in ten patients who are prescribed irinotecan for colon or pancreatic cancer has a mutation in the so-called UGT1A1 gene. As a result, the drug is less well broken down by the body, resulting in serious and sometimes life-threatening side effects. “The study shows that patients can be treated safely with a lower dose, without sacrificing effectiveness,” explains Deenen. The use of the DNA test also proves to be cost-effective, mainly due to the reduction in hospital admissions.
Whether a prescribed therapy works well and safely for a patient depends on the metabolism. Every patient has a different metabolism and therefore reacts differently to a drug. Some patients experience many side effects. In others, nothing happens at all and sometimes the drug turns out to be ineffective. A so-called DNA passport is drawn up in the laboratory on the basis of a tube of blood or saliva. Such a card shows the pharmacogenetic profile that indicates how the body responds to different drugs. “On the basis of that profile, I can prescribe the correct dose,” says oncologist-internist Geert-Jan Creemers of the Catharina Kanker Instituut.
In addition to the Catharina Hospital, the research was also conducted at the Erasmus MC, Haga hospital and the Leiden University Medical Center. The results of the study have changed the daily practice of the hospitals involved. The DNA test is used as standard in those hospitals.
Hospitals want to use test immediately
A recent poll among medical oncologists shows that more than seventy percent want to use this test immediately. “We have received calls from many hospitals to provide information on how the test can be performed in the private hospital,” said Maarten Deenen.
The DNA test is fairly easy for hospitals to perform. It is expected that the test will also be used internationally as a standard test. The Catharina Hospital performs the DNA test for all hospitals in the Eindhoven region on request.
The study was made possible financially by the Catharina Research Fund.