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BAP1 Syndrome — SCE Medical Oncology MCQ

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HardCancer GeneticsBAP1 SyndromeSCE Medical Oncology

A patient due to start capecitabine finished brivudine for herpes zoster 10 days ago. DPYD testing is normal. What is the safest SmPC-aligned action?

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Correct answer: C — Delay capecitabine until at least 4 weeks after the last brivudine dose

Brivudine potently inhibits DPD and can cause fatal fluoropyrimidine toxicity. The capecitabine SmPC requires at least a four-week interval after brivudine; a normal germline DPYD test does not neutralise acquired enzyme inhibition. Intravenous fluorouracil shares the interaction, and empirical dose reduction is not an acceptable substitute for the waiting interval.

Reference: Capecitabine UK SmPC. https://www.medicines.org.uk/emc/product/14545/smpc