Is personalized medicine a dream or a reality?

Area of Science:

• Pharmacogenomics
• Personalized Medicine
• Genomic Medicine

Background:

• Interindividual variability in drug response is influenced by genetics, demographics, drug interactions, disease states, and environment.
• Pharmacokinetic and pharmacodynamic factors mediate drug response variability.
• Personalized medicine aims to integrate genomic, clinical, and environmental data for optimized drug therapy.

Purpose of the Study:

• To review the feasibility and potential superiority of genomics-guided treatment options.
• To discuss the role of genetic variations in drug response for commonly used medications.
• To highlight challenges in implementing personalized medicine strategies.

Main Methods:

• Review of scientific literature on pharmacogenomics and personalized medicine.
• Analysis of genetic polymorphisms affecting drug disposition and targets.
• Case examples including warfarin, statins, clopidogrel, and tamoxifen.

Main Results:

• Genomic variations in CYP2C9 and VKORC1 significantly influence warfarin dose requirements.
• Polymorphisms in SLCO1B1 and ABCG2 contribute to variability in statin response and toxicity.
• Genetic factors impact the efficacy and safety of clopidogrel and tamoxifen.

Conclusions:

• Genomics-guided treatment is becoming feasible and shows promise for improved clinical outcomes and cost-benefit.
• Understanding all variables mediating drug response is crucial for successful genotype-guided therapy.
• Implementation challenges include cost, turnaround time, demonstrating clinical benefit, and healthcare professional training.