Certain changes in a gene known as UGT1A1 have been found to affect how quickly the body metabolizes the chemotherapy drug irinotecan from its active, to inactive form. This can affect drug activity, and the type and severity of side effects a person may experience. UGT1A1 genotyping has been proposed as a means of guiding use of irinotecan in the management of patients with metastatic colorectal cancer to improve effectiveness and reduce side effects.
EGAPP Recommendation Statement: The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group found that the evidence is currently insufficient to recommend for or against the routine use of UGT1A1 genotyping in patients with metastatic colorectal cancer who are to be treated with irinotecan, with the intent of modifying the dose as a way to avoid adverse drug reactions (severe neutropenia).
EGAPP Recommendation (January 2009)
Evidence Report (January 2009)
Summary Manuscript (January 2009)
CDC Summary of EGAPP Recommendation (July 2010)
Key Criteria: Prevalence and severity of colorectal cancer; irinotecan therapy is an increasingly common intervention; relevance to healthcare providers and patients for decision-making; FDA-approved test with potential impact on clinical practice.
Other Considerations: Limited literature that allows application of EGAPP methodology for a targeted review.
Page last updated: May 15, 2013
Page last reviewed: May 15, 2013
Content Source: OPHG Staff