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Pharmacogenomics insights into precision pediatric oncology
Kristie N Ramos1, David Gregornik2, Kenneth S Ramos3
1St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri.
Current Opinion in Pediatrics
|September 25, 2021
Summary
Pharmacogenomics can personalize drug doses and improve patient outcomes. This review highlights advances in thiopurine, anthracycline, and vincristine pharmacogenomics, paving the way for future precision medicine applications.
Area of Science:
- Pharmacogenomics
- Genomic Medicine
- Precision Therapeutics
Background:
- Interindividual genomic variability impacts medication response and toxicity.
- Pharmacogenomic guidance is not yet standard clinical practice.
- Optimizing drug therapy through genetic insights remains a key challenge.
Purpose of the Study:
- To review advances in pharmacogenomics for thiopurines, anthracyclines, and vincristine.
- To discuss the future actionability of pharmacogenomic data in clinical settings.
- To highlight the potential of personalized medicine in optimizing treatment.
Main Methods:
- Review of current literature on pharmacogenomic applications.
- Analysis of genetic variations influencing drug metabolism and toxicity.
- Synthesis of evidence for thiopurine, anthracycline, and vincristine pharmacogenomics.
Main Results:
- Thiopurine dosing guidelines incorporate thiopurine methyltransferase (TPMT) and NUDT15 genetic variations to prevent toxicity.
- Polygenic risk scores are emerging for predicting anthracycline-induced cardiotoxicity.
- CYP3A5 expression in children is associated with reduced vincristine-induced peripheral neuropathy risk.
Conclusions:
- Pharmacogenomic insights offer actionable strategies for thiopurine, anthracycline, and vincristine therapy.
- Future research should focus on pediatric trials, epigenetics, and precision survivorship.
- Integrating pharmacogenomics into standard care can enhance medication safety and efficacy.
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