The recently published NHS England and NHS Improvement urgent clinical policy statement for pharmacogenomic testing for DPYD polymorphisms with fluoropyrimidine therapies, follows recommendations issued by both the European Medicines Agency and the Medicines and Healthcare products Regulatory Agency. 

The urgent clinical policy statement states that:

• All patients, prior to commencing treatment with a fluoropyrimidine based therapy (5-fluorouracil, capecitabine or tegafur) should be screened for four DPYD gene variants which have been associated with fluoropyrimidine-associated toxicity.
• Within the clinical pathway, the genomic test should be ordered for eligible patients at the point of consent for fluoropyrimidine chemotherapy or earlier if appropriate.
• Guidance for clinicians on dosing adjustments for fluoropyrimidine therapy following detection of a DPYD variant has been published by the UK Chemotherapy Board to support implementation of the policy.

The South East GLH and the Synnovis Purine Research Laboratory will continue to provide DPYD testing service for the variants shown below.

• c.1679T>G p.(Ile560Ser)
• c.1905+1G>A
• c.2846A>T p.(Asp949Val)
• c.1236G>A/HapB3 p.(Glu412=) 

This is now a centrally commissioned NHSE service, so no invoices will be issued for eligible NHS patients.

PLEASE NOTE: During the first 6 month mobilisation period, the South East GLH has agreed to also provide a service for the North Thames and East Midlands East of England GLHs. Invoices will be raised for patients tested from outside South East GLH funded regions.