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Implementation of pharmacogenomics: Where are we now?
Samantha Medwid1,2,3, Richard B Kim1,2,3
1Department of Medicine, University of Western Ontario, London, Ontario, Canada.
British Journal of Clinical Pharmacology
|November 11, 2022
Summary
Pharmacogenomics (PGx) use is increasing due to improved testing. This review discusses PGx implementation, challenges like diversity, and future directions, using DPYD genotyping as a case study.
Area of Science:
- Pharmacogenomics
- Clinical Pharmacology
- Genetics
Background:
- Pharmacogenomics (PGx) research has a long history, focusing on genetic variations influencing drug response.
- Advances in cost and speed have accelerated the clinical adoption of PGx testing.
- Despite progress, widespread clinical implementation of PGx faces significant challenges.
Purpose of the Study:
- To review current models and evaluation methods for PGx delivery.
- To discuss clinically relevant PGx tests and associated medications.
- To highlight challenges and future directions in PGx implementation.
Main Methods:
- Review of current PGx delivery models and evaluation methodologies.
- Discussion of clinically actionable PGx tests and medications.
- Case study: Implementation of pre-emptive DPYD genotyping for fluoropyrimidine therapy in Ontario, Canada.
Main Results:
- PGx testing is gaining momentum in clinical settings due to improved accessibility.
- DPYD genotyping for fluoropyrimidine users is presented as an example of actionable PGx.
- Challenges include limited diversity in PGx studies and general adoption barriers.
Conclusions:
- Pharmacogenomics holds significant potential to become a standard of care.
- Addressing diversity and implementation barriers is crucial for broader PGx adoption.
- Future research should focus on new clinical targets, methodologies, and analysis approaches.
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