Overcoming Barriers to Discovery and Implementation of Equitable Pharmacogenomic Testing in Oncology

Area of Science:

• Pharmacogenomics and precision medicine in oncology.
• Genomic variation and its impact on drug response.
• Health equity in genetic research and application.

Background:

• Pharmacogenomics (PGx) is essential for personalized cancer treatments, optimizing drug efficacy and safety.
• Genetic ancestry influences drug response, yet PGx research often overlooks this, potentially creating disparities.
• Current PGx understanding and clinical use are disproportionately focused on individuals of European descent.

Purpose of the Study:

• To examine the bias in pharmacogenomics (PGx) research and application in oncology towards European ancestry groups.
• To discuss the implications of this bias on PGx discovery, access to care, and clinical implementation.
• To advocate for equitable PGx discovery and application in cancer care for all populations.

Main Methods:

• Review of current scientific understanding of PGx in oncology.
• Analysis of potential biases in PGx research and discovery related to genetic ancestry.
• Discussion of implications for clinical implementation, access, and understanding of PGx.

Main Results:

• PGx knowledge and clinical integration are more advanced for individuals of European descent compared to other groups.
• This bias can lead to disparities in cancer treatment outcomes and adverse drug events.
• Despite actionable findings and demonstrated benefits, PGx integration into routine oncology care remains limited.

Conclusions:

• The current state of pharmacogenomics (PGx) in oncology is not equitable across diverse genetic ancestry groups.
• Addressing biases in PGx research, discovery, and application is vital for achieving health equity in cancer care.
• Recommendations are proposed to overcome barriers and facilitate effective, equitable PGx implementation in oncology.