UGT1A1*28 Guided Dosing Strategies With Nalirifox in Metastatic Pancreatic Ductal Adenocarcinoma

This segment focuses on the practical management of patients with metastatic pancreatic ductal adenocarcinoma who are UGT1A1*28 homozygous and are being considered for treatment with Nalirifox. Faculty discuss how genetic variation in irinotecan metabolism informs dosing and monitoring strategies without excluding patients from effective therapy.

Panelists explain how UGT1A1 testing results are integrated into clinical decision making, including adjustments to starting dose, frequency of laboratory monitoring, and early toxicity surveillance. Rather than using UGT1A1 status as a barrier to treatment, faculty emphasize a risk adapted approach that allows patients to benefit from Nalirifox while minimizing the likelihood of severe adverse events.

The discussion highlights how proactive management, patient education, and early intervention are essential for maintaining treatment continuity in this population. Faculty also describe how real world experience has increased confidence in safely treating UGT1A1*28 homozygous patients when appropriate safeguards are in place.

Overall, this segment provides practical guidance for incorporating pharmacogenomic information into routine care for metastatic pancreatic ductal adenocarcinoma, reinforcing that individualized dosing strategies can support both safety and sustained clinical benefit.