Toward individualized treatment: prediction of anticancer drug disposition and toxicity with pharmacogenetics

John F Deeken1, William D Figg, Susan E Bates

  • 1Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20895, USA.

Anti-Cancer Drugs
|December 13, 2006
PubMed

Insights

Pharmacogenetics improves anticancer drug efficacy by tailoring treatments to individual patient genetic profiles. Understanding genetic variations in drug metabolism and transport enhances chemotherapy outcomes and reduces variability.

Area of Science:

  • Pharmacology
  • Oncology
  • Genetics

Background:

  • Individual variability in anticancer drug handling impacts treatment effectiveness.
  • Physiological, genetic (pharmacogenetics), and environmental factors influence drug concentration-time profiles.
  • Improving the therapeutic index of anticancer drugs is a key challenge in oncology.

Purpose of the Study:

  • To evaluate strategies for personalizing anticancer drug therapy.
  • To implement pharmacogenetic imprinting through patient genotyping or phenotyping.
  • To enhance the therapeutic outcomes of chemotherapy.

Main Methods:

  • Focus on genetic variants in drug-metabolizing enzymes (e.g., thiopurine S-methyltransferase, cytochrome P450 family).
  • Analysis of genetic variations in ATP-binding cassette transporters (e.g., ABCB1, ABCG2).
  • Genotyping and phenotyping of individual cancer patients.

Main Results:

  • Pharmacogenetic strategies demonstrate a substantial impact on therapeutic outcomes.
  • Identification of key gene variants influencing drug response.
  • Variability in drug handling is linked to genetic characteristics.

Conclusions:

  • Pharmacogenetic approaches are crucial for optimizing anticancer chemotherapy.
  • Genotyping cancer patients can lead to improved treatment efficacy.
  • Personalized medicine through pharmacogenetics holds promise for better cancer treatment.

Related Concept Videos

Pharmacogenomics: Identification of New Drug Targets01:29

Pharmacogenomics: Identification of New Drug Targets

Advances in genomics have profoundly influenced drug discovery by increasing both the speed and accuracy of pharmaceutical development. Pharmacogenomics, which examines how genetic variation influences drug response, facilitates the identification of novel therapeutic targets and enables patient stratification for personalized treatment. These strategies contribute to improved drug efficacy, minimized adverse effects, and more efficient clinical trial design.Mapping genetic differences...
Pharmacogenetics of Drug Metabolism: Overview01:27

Pharmacogenetics of Drug Metabolism: Overview

Genetic polymorphism in drug metabolism is crucial to the inter-individual variability observed in drug responses. Drug metabolism primarily involves the chemical modification of drugs and other xenobiotics to enhance their elimination by increasing their polarity. Two main classes of enzymes mediate this biotransformation process: Phase I enzymes, primarily cytochrome P450s, catalyze oxidation and reduction reactions, while other enzymes, such as esterases, mediate hydrolysis, and Phase II...
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
Pharmacogenetics and Pharmacogenomics: Overview01:29

Pharmacogenetics and Pharmacogenomics: Overview

Pharmacogenetics and pharmacogenomics examine how genetic factors influence an individual's response to drugs. While pharmacogenetics focuses on the impact of specific genetic variants on drug effects, pharmacogenomics takes a broader approach, studying how genetic variation across populations contributes to differences in drug responses. These fields aim to explain why individuals may experience varying levels of efficacy or adverse reactions to the same medication.Variability in drug...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...