CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1591120
This article is part of the Research TopicUpdates on Pharmacogenomics Role in Cancer ChemotherapyView all 4 articles
Trifluridine and Tipiracil-Induced DPD Inhibition Mimicking DPD Deficiency: A Case Report
Provisionally accepted
- 1Centre Georges François Leclerc, Dijon, France
- 2Centre Hospitalier Universitaire de Besançon, Besancon, Franche-Comté, France
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Fluoropyrimidines (5-FU and its derivatives remain the standard first-line treatment for metastatic colorectal cancer (mCRC). In recent years, trifluridine/tipiracil (TAS-102), an orally administered combination drug, has become a common third-line therapy for mCRC and could increasingly be used as first-line treatment. We report, for the first time, the case of an mCRC patient presenting discrepancies in uracilemia between measurements taken during (43.0 µg/L) or outside trifluridine/tipiracil treatment (7.3 and 4.5 µg/L). This inconsistency could be attributed to the metabolism of trifluridine into 5-carboxyuracil (5-CU), which can interfere with DPD phenotyping and cause falsely elevated uracilemia. This can lead to unnecessary reduction in the dose of fluoropyrimidines. Clinicians should be aware of this potential interaction when performing DPD phenotyping in patients treated with trifluridine/tipiracil, ensuring that testing is performed either before the treatment begins or after it has finshed, or alternatively genotyping DPYD.
Keywords: Trifluridine, Tipiracil, DPD deficiency, Metastatic colorectal cancer, case report, Uracilemia
Received: 10 Mar 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Schmitt, Boulet, Royer and Ghiringhelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Antonin Schmitt, Centre Georges François Leclerc, Dijon, France
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