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    Irinotecan Toxicity Risk Panel

    2 minute(s) read
    Information by
    Bangkok Hospital Phuket
    Updated on: 23 Dec 2025
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    Genolife Service
    Irinotecan Toxicity Risk Panel
    Bangkok Hospital Phuket
    Updated on: 23 Dec 2025

    UGT1A1 Pharmacogenomic Testing

    Why Genotyping Changes Outcomes

    Understanding the genetic link to Irinotecan toxicity.

    Mechanism of Toxicity

    Irinotecan’s active metabolite (SN-38) is inactivated by UGT1A1. Reduced-function alleles (*28, *6) slow this process, increasing SN-38 exposure and the risk of severe side effects.

    Who’s at Risk?

    About 10% of North Americans are *28/*28 homozygotes. The *6 allele is common in East Asians (15-30%), predicting higher toxicity risk in these groups.

    How Common Are the Risk Alleles?

    UGT1A1*28 allele: ~0.26–0.31 in Caucasians; ~0.42–0.56 in African Americans; ~0.09–0.16 in Asians. 
    UGT1A1*6 allele: ~0.15–0.30 in Chinese, Korean, and Japanese populations.  

    Who Should Be Tested?

    Identifying ideal candidates for pharmacogenomic testing.

    • Patients starting irinotecan at ≥180 mg/m² or as single-agent – Highest genotype–toxicity signal; informs initial dosing

    • Individuals with prior unexplained neutropenia/diarrhea on irinotecan – Possible UGT1A1 poor/intermediate metabolizer

    • East Asian ancestry (common *6) or known *28 family history – Elevated prevalence of reduced-function alleles

    • Fragile patients (elderly, comorbid, polypharmacy) – Preventable toxicity may derail treatment plan


    Your Journey with Genolife Services

    A clear path to optimizing Irinotecan therapy.

    Pre-test Counselling

    Discuss benefits, limits, and alternative irinotecan dosing strategies.

    Sample Collection

    A simple blood sample is all that’s needed (no fasting required).

    Expert Interpretation

    Results are reviewed by a team including a Clinical Geneticist, Pharmacist, and Oncologist.

     

    Post test

    Offered for relatives who may also need irinotecan or have a history of related toxicity.

     

    Ready to plan for a safer health future?

    Contact us for a consultation with our Genetic Counselor/Pharmacogenomics Specialist about the Irinotecan Toxicity Risk Panel or other genetic tests.

    Book a Consultation


    References

    • NCBI Medical Genetics Summaries. Irinotecan Therapy and UGT1A1 Genotype. Updated overview of mechanism, allele frequencies, FDA labeling, and dose-toxicity relationships.
    • PharmGKB. Irinotecan + UGT1A1 clinical and variant annotations; allele frequency resources. 
    • CPIC. UGT1A1–Irinotecan evidence status update (workstream). Confirms active evaluation of dosing guidance within CPIC


     

    For more information, please contact

    Genolife Services

    4th Floor

    [email protected]

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