• Dr. Hertz Daniel

CV

Dan Hertz is an Associate Professor at the University of Michigan College of Pharmacy.

He received his PharmD from Rutgers University and PhD from University of North Carolina under Dr. Howard McLeod. Dr. Hertz’s research focuses on developing individualized treatment strategies for patients with cancer and translating them into clinical practice.

He has particular interests in biomarkers of taxane-induced neuropathy and DPYD testing to prevent severe fluoropyrimidine toxicity, including his role as a medical advisor to Advocates for Universal DPD/DPYD Testing (AUDT).

ABSTRACT

Fluoropyrimidines such as 5-fluorouracil and capecitabine are widely used in cancer treatment but carry a significant risk of severe, sometimes fatal toxicity in patients with reduced dihydropyrimidine dehydrogenase (DPD) activity due to inherited DPYD genetic variants.

This presentation will explore the clinical implications of DPYD variation and its impact on fluoropyrimidine safety. Despite evidence of clinical utility for pre-treatment DPYD testing, adoption in the U.S. remains limited. I will discuss the key barriers to implementation, including evidentiary, logistical, and educational challenges. The talk will also review current guidance from major U.S. professional organizations—specifically ASCO and NCCN—highlighting how their recommendations on DPYD testing have evolved.

In addition, I will examine the FDA’s stance on DPYD testing, including labeling language and dosing considerations. By comparing these perspectives, the presentation aims to clarify the current regulatory and guideline landscape, identify gaps, and suggest opportunities to improve the safe use of fluoropyrimidines through DPYD testing and personalized dosing.