Clinical Implications of Pharmacogenomic Testing in the Real World—Insights From a Pediatric Program

Abstract

Pharmacogenomics aims to improve medication safety and dosing by incorporating the guidance of patients' genetic information into treatment decisions. While pharmacogenomic (PGx) testing has become more widely available and less costly, its use in routine clinical care has lagged. Major barriers to implementation have included the difficulty of interpreting test results in practice and the need for clinician education and decision-making support. Over the past decade, organizations such as the Clinical Pharmacogenetic Implementation Consortium have addressed these barriers by evaluating the strength of evidence for the actionability of gene-drug associations. 1 Evidence-based guidelines for the use of PGx information in treatment decisions are currently available for more than 35 genedrug pairs covering a wide range of medications, including oncologic agents and antidepressant and pain medications. 1 However, guidelines do not provide recommendations on when to order PGx tests, and a major question in the field is whether these tests should be offered reactively, based on