Prevention of adverse drug effects: a pharmacogenomic approach

Area of Science:

• Pharmacogenetics
• Cardiology
• Oncology

Background:

• Adverse drug reactions (ADRs), including anthracycline-induced cardiotoxicity (ACT), significantly impact patient quality of life.
• ACT affects up to 65% of patients, potentially leading to congestive heart failure.
• Pharmacogenetics has elucidated ACT mechanisms, guiding current prevention strategies.

Purpose of the Study:

• To review recent advances in pharmacogenetic studies for ACT.
• To highlight novel methods implicating dysregulated genes and biological pathways in ACT.
• To inform clinical treatment strategies and refine practice guidelines for ACT prevention.

Main Methods:

• Review of recent pharmacogenetic studies on ACT.
• Analysis of novel methods for identifying genetic and pathway dysregulation.
• Evaluation of evidence for clinical translation and guideline development.

Main Results:

• Few pharmacogenetic studies have translated into clinical guidelines or genetic testing for ACT.
• Lack of cohort replication and pathway validation hinders clinical implementation.
• Recent advances utilize novel methods to directly link genes and pathways to anthracycline treatment response.

Conclusions:

• Further understanding of ACT genetics and pathways via novel methods is crucial.
• This knowledge can inform clinical treatment and refine practice guidelines.
• Improved clinical pharmacogenetic testing can reduce ACT incidence in pediatric cancer patients.