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Bill

A 2645

Requires physician to offer to test patient for dihydropyrimidine dehydrogenase deficiency prior to patient undergoing chemotherapy.

2026-2027 Regular Session Introduced by Chris DePhillips

Requires physicians to offer DPD genetic testing before chemotherapy to prevent severe drug toxicity in deficient patients, standardizing FDA-recommended screening practice.

Introduced, Referred to Assembly Health Committee
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Bill Summary · A 2645

Legislative bill overview

Bill A 2645 requires physicians to offer genetic testing for dihydropyrimidine dehydrogenase (DPD) deficiency before administering chemotherapy to patients. DPD deficiency is a metabolic disorder that impairs the body's ability to break down certain chemotherapy drugs, potentially leading to severe toxicity. The bill mandates this as a standard pre-treatment offering rather than making it optional or purely clinician-discretionary.

Why is this important

Patients with undetected DPD deficiency face significantly elevated risk of severe adverse reactions and death from fluoropyrimidine chemotherapy drugs (like 5-fluorouracil), which are commonly used to treat colorectal, breast, and other cancers. The FDA has recommended DPD testing since 2020, but adoption remains inconsistent; this bill would standardize the practice across New Jersey. Early identification allows physicians to adjust dosages or select alternative treatments, potentially saving lives.

Potential points of contention

  • Cost and access: Who bears the cost of genetic testing? Insurance coverage varies, and mandatory testing could increase healthcare expenses or create barriers for uninsured/underinsured patients.
  • Medical autonomy: Whether legislature should mandate specific pre-treatment protocols versus allowing physicians clinical discretion based on individual patient circumstances.
  • Testing accuracy and followup: Questions about which populations benefit most, false positive rates, and whether the bill adequately addresses what physicians should do with results.

Compiled from official sources — confirm details with the bill’s official record.

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