{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:04:27Z","timestamp":1791921867685,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Fluoropyrimidines are a vital component of chemotherapy regimens. Deleterious\n                    <jats:italic>DPYD<\/jats:italic>\n                    variants reduce activity of dihydropyrimidine dehydrogenase, the rate\u2010limiting enzyme of fluoropyrimidine catabolism, resulting in reduced fluoropyrimidine clearance and elevated risk of life\u2010threatening toxicities.\n                    <jats:italic>DPYD<\/jats:italic>\n                    genotype\u2010guided fluoropyrimidine therapy can mitigate the risk of severe life\u2010threatening toxicities, but adoption of testing globally has been limited. We developed a 91\u2010item survey investigating global\n                    <jats:italic>DPYD<\/jats:italic>\n                    implementation strategies to gain insight into common practices and successful strategies. The survey was disseminated to Pharmacogenomics Global Research Network Implementation Working Group members consisting of 54 health care sites across 15 countries. Survey responses were received from 28 sites (52%) across 9 countries. Over 80% of sites implemented, or planned to implement, a preemptive testing strategy (i.e., before a fluoropyrimidine is administered) leveraging the electronic health record (EHR) to disseminate\n                    <jats:italic>DPYD<\/jats:italic>\n                    results to providers. All sites created infrastructure to support\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing (e.g., order sets, EHR decision support), but 70% of sites indicated reliance on clinicians to remember test ordering. Only 2 sites reported high\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing rates (&gt;\u200975%) among patients planned to receive a fluoropyrimidine. Most sites (57%) used in\u2010house clinical laboratories that tested for the majority of\n                    <jats:italic>DPYD<\/jats:italic>\n                    Tier 1 variants. Among sites that had implemented\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing, the median turnaround time was 10\u2009days. Few sites indicated that a high percentage (&gt;\u200975%) of\n                    <jats:italic>DPYD<\/jats:italic>\n                    results were returned before fluoropyrimidine administration. Our results suggest that additional implementation strategies are needed, addressing barriers and facilitators of\n                    <jats:italic>DPYD<\/jats:italic>\n                    testing.\n                  <\/jats:p>","DOI":"10.1111\/cts.70466","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T07:21:16Z","timestamp":1766906476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Global Investigation of Clinical Implementation Strategies for\n                    <scp>\n                      <i>DPYD<\/i>\n                    <\/scp>\n                    Testing to Guide Fluoropyrimidine Therapy"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1652-3773","authenticated-orcid":false,"given":"Nihal","family":"El Rouby","sequence":"first","affiliation":[{"name":"Division of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy University of Cincinnati  Cincinnati Ohio USA"},{"name":"St. Elizabeth Healthcare  Edgewood Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Aquilante","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences  Aurora Colorado USA"},{"name":"Colorado Center for Personalized Medicine University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9675-7523","authenticated-orcid":false,"given":"Salma A.","family":"Bargal","sequence":"additional","affiliation":[{"name":"Department of Medicine and Program for Personalized and Genomic Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-5292","authenticated-orcid":false,"given":"Larisa H.","family":"Cavallari","sequence":"additional","affiliation":[{"name":"Center for Pharmacogenomics and Precision Medicine and Department of Pharmacotherapy and Translational Research University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio D.","family":"Duarte","sequence":"additional","affiliation":[{"name":"Center for Pharmacogenomics and Precision Medicine and Department of Pharmacotherapy and Translational Research University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Gunderson","sequence":"additional","affiliation":[{"name":"Aaron W Perlman Center for Cerebral Palsy Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tinashe","family":"Mazhindu","sequence":"additional","affiliation":[{"name":"Department of Oncology African Institute for Biomedical Sciences and Technology and University of Zimbabwe  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9807-788X","authenticated-orcid":false,"given":"Mohamed","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Services and Sciences Children's Cancer Hospital  Cairo Egypt"},{"name":"Personalized Medication Management Unit Children's Cancer Hospital  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-2176","authenticated-orcid":false,"given":"Xiaoyan","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy Peking University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Grace","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Cancer Pharmacology &amp; Pharmacogenomics Atrium Health Levine Cancer  Charlotte North Carolina USA"},{"name":"Atrium Health Wake Forest Baptist Comprehensive Cancer Center  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai N.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Cancer Pharmacology &amp; Pharmacogenomics Atrium Health Levine Cancer  Charlotte North Carolina USA"},{"name":"Atrium Health Wake Forest Baptist Comprehensive Cancer Center  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3849-374X","authenticated-orcid":false,"given":"Todd C.","family":"Skaar","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-2936","authenticated-orcid":false,"given":"D. Max","family":"Smith","sequence":"additional","affiliation":[{"name":"MedStar Health  Columbia Maryland USA"},{"name":"Georgetown University Medical Center  Washington DC District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7007-3289","authenticated-orcid":false,"given":"Sony","family":"Tuteja","sequence":"additional","affiliation":[{"name":"Division of Translational Medicine and Human Genetics, Department of Medicine Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron H. N.","family":"van Schaik","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2314-0164","authenticated-orcid":false,"given":"J. 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