二氢嘧啶脱氢酶 (DPD) 缺乏症患者因氟嘧啶 (FP) 化疗而面临严重和致命毒性的高风险。治疗前 DPYD 检测是许多国家的护理标准，但美国 (US) 并非如此。这项调查评估了美国的治疗前 DPYD 测试方法，以确定更广泛采用的最佳实践。从 2023 年 8 月到 10 月，向已知进行治疗前 DPYD 测试的机构和临床医生发送了一份包含 22 项的 QualtricsXM 调查，并通过以下渠道广泛分发：相关组织和社交网络。使用描述性分析对响应进行了分析。对来自 24 个已实施治疗前 DPYD 测试或制定了详细实施计划的独特美国站点的响应进行了分析。只有 33% 的中心要求对所有 FP 治疗的患者进行 DPYD 检测；在其余地点，根据疾病特征或临床医生的偏好对患者进行测试。近 50% 的站点依靠个别临床医生来记住订购检测，而无需电子警报或工作流程提醒的帮助。 DPYD 测试通常由商业实验室进行，这些实验室至少测试了四种或五种被认为具有临床可行性的 DPYD 变体。大约 90% 的站点报告在订购后 10 天内收到结果。将 DPYD 测试纳入常规临床实践是可行的，需要医疗团队之间的协调努力。这些结果将用于制定临床采用 DPYD 测试的最佳实践，以防止接受 FP 化疗的癌症患者发生严重和致命的毒性。© 2024。作者获得 Springer-Verlag GmbH 德国公司的独家许可，该公司是施普林格自然。

Patients with dihydropyrimidine dehydrogenase (DPD) deficiency are at high risk for severe and fatal toxicity from fluoropyrimidine (FP) chemotherapy. Pre-treatment DPYD testing is standard of care in many countries, but not the United States (US). This survey assessed pre-treatment DPYD testing approaches in the US to identify best practices for broader adoption.From August to October 2023, a 22-item QualtricsXM survey was sent to institutions and clinicians known to conduct pre-treatment DPYD testing and broadly distributed through relevant organizations and social networks. Responses were analyzed using descriptive analysis.Responses from 24 unique US sites that have implemented pre-treatment DPYD testing or have a detailed implementation plan in place were analyzed. Only 33% of sites ordered DPYD testing for all FP-treated patients; at the remaining sites, patients were tested depending on disease characteristics or clinician preference. Almost 50% of sites depend on individual clinicians to remember to order testing without the assistance of electronic alerts or workflow reminders. DPYD testing was most often conducted by commercial laboratories that tested for at least the four or five DPYD variants considered clinically actionable. Approximately 90% of sites reported receiving results within 10 days of ordering.Implementing DPYD testing into routine clinical practice is feasible and requires a coordinated effort among the healthcare team. These results will be used to develop best practices for the clinical adoption of DPYD testing to prevent severe and fatal toxicity in cancer patients receiving FP chemotherapy.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.