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Individualized drug therapy

Ann K Daly1

  • 1School of Clinical and Laboratory Sciences, Newcastle University Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. a.k.daly@ncl.ac.uk

Current Opinion in Drug Discovery & Development
|February 3, 2007
PubMed

Insights

Pharmacogenetics guides personalized medicine by tailoring drug treatments based on individual genetic makeup. Genetic testing helps predict drug toxicity and efficacy, improving patient outcomes and healthcare.

Area of Science:

  • Pharmacogenomics and Personalized Medicine
  • Clinical Pharmacology
  • Genetics and Drug Development

Background:

  • Pharmacogenetics is advancing personalized medicine, particularly in oncology with targeted therapies like trastuzumab and erlotinib.
  • Genetic testing is increasingly used to individualize existing treatments beyond cancer, predicting drug toxicity and response.
  • Cytochrome P450 (CYP) gene polymorphisms are well-studied for their impact on drug metabolism, though clinical application for treatment individualization is still limited.

Purpose of the Study:

  • To review the current applications and potential of pharmacogenetics in tailoring medical treatments.
  • To highlight specific examples of pharmacogenetic tests influencing drug prescription and toxicity prediction.
  • To discuss the future prospects and challenges for integrating pharmacogenetics into routine healthcare.

Main Methods:

  • Literature review of pharmacogenetic studies and clinical applications.
  • Analysis of specific gene-drug interactions and their clinical utility.
  • Discussion of the role of genetic polymorphisms in drug response and toxicity.

Main Results:

  • Pharmacogenetic insights enable the development of targeted antitumor drugs and the individualization of existing therapies.
  • Genetic markers for thiopurine S-methyltransferase and uridine 5'-diphosphoglucuronosyl-transferase 1A1 predict toxicity for specific chemotherapies.
  • CYP2C9, CYP2D6, CYP2C19, and CYP3A5 genotypes, along with vitamin K epoxide reductase complex subunit 1, show potential for individualizing anticoagulant and other drug treatments.
  • Emerging data links beta2-adrenoceptor gene variants to response variability for beta2-adrenoceptor agonists.

Conclusions:

  • Pharmacogenetics offers significant potential for optimizing drug therapy and improving patient outcomes through personalized medicine.
  • Wider adoption requires demonstrating cost-effectiveness and ensuring the availability of accessible genetic testing systems.
  • Continued research into gene-drug interactions and receptor genetics will further refine individualized treatment strategies.

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