{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:00:14Z","timestamp":1792699214245,"version":"4.5.0"},"reference-count":101,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>\n                    The safety of systemic fluoropyrimidines (e.g., 5\u2010fluorouracil, capecitabine) is impacted by germline genetic variants in\n                    <jats:italic>DPYD,<\/jats:italic>\n                    which encodes the dihydropyrimidine dehydrogenase (DPD) enzyme that functions as the rate\u2010limiting step in the catabolism of this drug class. Genetic testing to identify those with DPD deficiency can help mitigate the risk of severe and life\u2010threatening fluoropyrimidine\u2010induced toxicities. Globally, the integration of\n                    <jats:italic>DPYD<\/jats:italic>\n                    genetic testing into patient care has varied greatly, ranging from being required as the standard of care in some countries to limited clinical use in others. Thus, implementation strategies have evolved differently across health systems and countries. The primary objective of this tutorial is to provide practical considerations and best practice recommendations for the implementation of\n                    <jats:italic>DPYD<\/jats:italic>\n                    \u2010guided systemic fluoropyrimidine dosing. We adapted the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to cover topics including the clinical evidence supporting\n                    <jats:italic>DPYD<\/jats:italic>\n                    genotyping to guide fluoropyrimidine therapy, regulatory guidance for\n                    <jats:italic>DPYD<\/jats:italic>\n                    genotyping, key stakeholder engagement, logistics for\n                    <jats:italic>DPYD<\/jats:italic>\n                    genotyping, development of point\u2010of\u2010care clinical decision support tools, and considerations for the creation of sustainable and scalable\n                    <jats:italic>DPYD<\/jats:italic>\n                    genotype\u2010integrated workflows. This guide also describes approaches to counseling patients about\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing and result disclosure, along with examples of patient and provider educational resources. Together,\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing and clinical practice integration aim to promote safe prescribing of fluoropyrimidine therapy and decrease the risk of severe and life\u2010threatening fluoropyrimidine toxicities.\n                  <\/jats:p>","DOI":"10.1002\/cpt.3567","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T03:38:38Z","timestamp":1738294718000},"page":"1194-1208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["A Guide for Implementing\n                    <i>DPYD<\/i>\n                    Genotyping for Systemic Fluoropyrimidines into Clinical Practice"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2489-3099","authenticated-orcid":false,"given":"Teresa T.","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Pathology H. 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