Prevalence of Dihydropyridine Dehydrogenase (DPD) Deficiency in Cancer Patients in Senegal

Introduction: Cancers are a real public health problem. Their prevalence varies greatly among the world population and many therapeutic strategies, such as chemotherapy, have been put in place and most chemotherapy protocols are based on products containing fluoropyrimidines. However, the use of the suggested products can cause side effects in patients who are deficient in dihydropyrimidine dehydrogenase enzyme, which plays an important role in the metabolism of fluoropyrimidine products. Our study was conducted in this context to determine the activity of this enzyme in a population with cancer.

Methods: This is a prospective study whose sample collection took place during the months of July and August 2021. The study involved 103 cancer patients were selected following a questionnaire and a consultation of the chemotherapy protocol. Blood samples were taken on EDTA tubes and uracil (U) and dihydrouracil (UH2) were measured using HPLC.

Results: In our study population, the mean age is 49.77 years ±2.46 years. And women were the most affected, representing 83% of patients and a sex ratio of 0.19. 47% of women had breast cancer, 25% had cervical cancer, 6% had ovarian cancer, 3% had rectal cancer, and 1% had other types of cancers such as vulvar, bladder, stomach, pelvic colon, chest, throat, and cheek/eye and cavirum. For the UH2/U ratio, the mean value was 12.6 ± 0.48 with a standard deviation of 4.91 ± 0.95. DPD activity was normal in 33% of our patients, while 66.9% had a partial deficit and 0.1% had a total deficit. The 40 to 50 years and 50 to 60 age groups had high deficiency in this enzyme (21.3% and 20.3% respectively), with a total deficiency observed specifically in the 40 to 50 age group.

Conclusion: The results of our study highlighted the importance of screening for DPD deficiency prior to fluoropyrimidine administration. Screening makes it possible to identify patients at risk and to adapt chemotherapy doses, accordingly, thus reducing the incidence of severe and potentially fatal toxicities.