Utilization of polygenic risk scores in drug development protocols

The development of polygenic risk scores (PRSs), which make use of genetic testing to assess an individual's risk of developing certain diseases or conditions based on collective genetic variant information, can be applied in drug development to enrich clinical trials or predict response to treatment. From querying documents submitted to the Food & Drug Administration, the landscape of use of PRSs across time shows increased use in guiding clinical trials. Of the clinical trial protocols submitted, most were in the therapeutic areas of neurology, radiology (imaging and diagnostic pharmaceuticals), psychiatry, and oncology. Use of PRSs in clinical trials is most frequent in early drug development (phase 1, phase 1/2, or phase 3) and generally supports secondary or exploratory analyses. Additionally, about half of the protocols developed novel PRSs, and the other half used preexisting PRSs. As researchers, regulators, and clinicians aim to understand the results and implications of PRSs in clinical trials, the continued use of PRSs, despite being less common, reinforces the need for further exploration.