Pharmacogenomics in oncology care

Filipski, Kelly K.; Mechanic, Leah E.; Long, Rochelle M.; Freedman, Andrew

doi:10.3389/fgene.2014.00073

Cited by 35 publications

(35 citation statements)

References 30 publications

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“…The prodrug tamoxifen is a selective estrogen receptor (ER) modulator used to treat ER-positive breast cancer patients [52]. Tamoxifen is actively catalyzed to endoxifen and 4-hydroxytamoxifen by various CYPs with CYP2D6 acting as the rate-limiting enzyme [53].…”

Section: Influence Of Polymorphisms In Genes Encoding Phase-i Drug Mementioning

confidence: 99%

Pharmacogenomics of Drug Metabolizing Enzymes and Transporters: Relevance to Precision Medicine

Ahmed

Zhou

et al. 2016

Genomics, Proteomics &Amp; Bioinformatics

249

159

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The interindividual genetic variations in drug metabolizing enzymes and transporters influence the efficacy and toxicity of numerous drugs. As a fundamental element in precision medicine, pharmacogenomics, the study of responses of individuals to medication based on their genomic information, enables the evaluation of some specific genetic variants responsible for an individual’s particular drug response. In this article, we review the contributions of genetic polymorphisms to major individual variations in drug pharmacotherapy, focusing specifically on the pharmacogenomics of phase-I drug metabolizing enzymes and transporters. Substantial frequency differences in key variants of drug metabolizing enzymes and transporters, as well as their possible functional consequences, have also been discussed across geographic regions. The current effort illustrates the common presence of variability in drug responses among individuals and across all geographic regions. This information will aid health-care professionals in prescribing the most appropriate treatment aimed at achieving the best possible beneficial outcomes while avoiding unwanted effects for a particular patient.

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Section: Influence Of Polymorphisms In Genes Encoding Phase-i Drug Mementioning

confidence: 99%

Pharmacogenomics of Drug Metabolizing Enzymes and Transporters: Relevance to Precision Medicine

Ahmed

Zhou

et al. 2016

Genomics, Proteomics &Amp; Bioinformatics

249

159

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show abstract

“…Several FDA-approved medications, used to treat a variety of cancers (e.g., lung, breast, and gastrointestinal tumors), can be paired with biomarkers to personalize treatment (2). Although germline variation that affects the development of a tumor can also help to predict the therapeutic and adverse effects of anticancer drugs (17, 18), most of the pharmacogenetic options in oncology involve somatic or acquired mutations, which often predict the pharmacodynamic effects of oncologic drugs (19–22). …”

Section: Precision Medicine: Advances In Oncologic Cardiovascular Amentioning

confidence: 99%

Precision medicine and pharmacogenetics: what does oncology have that addiction medicine does not?

Kranzler

Smith²,

Schnoll

et al. 2017

Addiction

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Background and aims Precision, personalized, or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e., pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation. We also considered why progress in this effort has lagged in addiction medicine. Methods We compared the development of pharmacogenetic biomarkers in oncology, cardiovascular medicine (where developments are also promising), and addictive disorders. Results The first major reason for the success of oncologic pharmacogenetics is ready access to tumor tissue, which allows in vitro testing and insights into cancer biology. The second major reason is funding, with cancer research receiving, by far, the largest allocation by the National Institutes of Health (NIH) over the past two decades. The second largest allocation of research funding has gone to cardiovascular disease research. Addictions research received a much smaller NIH funding allocation, despite the major impact that tobacco use, alcohol consumption, and illicit drug use have on the public health and healthcare costs. Conclusions Greater support for research on the personalized treatment of addictive disorders can be expected to yield disproportionately large benefits to the public health and substantial reductions in healthcare costs.

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“…Therefore, alternative study designs are often necessary to explore the clinical utility of pharmacogenetic testing. 7 …”

Section: Current Practice Of Evaluating Pharmacogenetic Evidencementioning

confidence: 99%

Evidence and resources to implement pharmacogenetic knowledge for precision medicine

Caudle

Gammal

Whirl‐Carrillo

et al. 2016

American Journal of Health-System Pharmacy

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Purpose Implementation of pharmacogenetics into clinical practice has been relatively slow despite substantial scientific progress over the last decade. One barrier that inhibits uptake of pharmacogenetics into routine clinical practice is the lack of knowledge of how to translate a genetic test into a clinical action based on current evidence. The purpose of this paper is to describe the current state of pharmacogenetic evidence and evidence-based resources that facilitate the uptake of pharmacogenetics into clinical practice. Summary Controversy exists over the required evidence threshold needed for routine clinical implementation of pharmacogenetics. Large randomized controlled trials are not clinically feasible or necessary for many pharmacogenetic applications. Online resources exist like the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Pharmacogenomics Knowledgebase (PharmGKB) that provide freely available, evidence-based resources that facilitate the translation of genetic laboratory test results into actionable prescribing recommendations for specific drugs. Conclusion Resources provided by organizations such as CPIC and PharmGKB that use standardized approaches to evaluate the literature and provide clinical guidance are essential for the implementation of pharmacogenetics into routine clinical practice.

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Pharmacogenomics in oncology care

Cited by 35 publications

References 30 publications

Pharmacogenomics of Drug Metabolizing Enzymes and Transporters: Relevance to Precision Medicine

Pharmacogenomics of Drug Metabolizing Enzymes and Transporters: Relevance to Precision Medicine

Precision medicine and pharmacogenetics: what does oncology have that addiction medicine does not?

Evidence and resources to implement pharmacogenetic knowledge for precision medicine

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