Impact of pharmacogenomics on the clinical laboratory

Clinical pharmacogenomics promises to increase the safety and efficacy of drug prescription, decrease the incidence of adverse drug reactions, help improve public health, and presage in an era of personalized, predictive, and prophylactic medicine. Clinical pharmacogenomics stands to be broad based and include the following laboratory components: new and expanded pharmacogenetic tests, disease profiles, chemopredictive testing, and risk profiling. There is a growing body of evidence that variable drug responsiveness is caused by polymorphisms within multiple genes, protein products of which are involved in critical metabolic and/or physiologic pathways relevant for drug action. Different pharmacogenomic approaches will be used to discover a new generation of unique and highly predictive pharmacogenetic tests that the clinical laboratory will employ to help identify patient responder populations. Disease profiling and chemopredictive testing will routinely be applied to accurately screen for disease and help guide therapeutic course of action. A growing number of risk-profiling tests will assist in predicting a patient's predisposition to disease. Clinical pharmacogenomics stands to become the basis for the new millennium's practice of medicine and have a profound impact on the clinical laboratory.