The Value of Pharmacogenetics to Reduce Drug-Related Toxicity in Cancer Patients

被引:0
|
作者
Doreen Z. Mhandire
Andrew K. L. Goey
机构
[1] Roswell Park Comprehensive Cancer Center,Department of Pharmacology and Therapeutics
来源
Molecular Diagnosis & Therapy | 2022年 / 26卷
关键词
D O I
暂无
中图分类号
学科分类号
摘要
Many anticancer drugs cause adverse drug reactions (ADRs) that negatively impact safety and reduce quality of life. The typical narrow therapeutic range and exposure-response relationships described for anticancer drugs make precision dosing critical to ensure safe and effective drug exposure. Germline mutations in pharmacogenes contribute to inter-patient variability in pharmacokinetics and pharmacodynamics of anticancer drugs. Patients carrying reduced-activity or loss-of-function alleles are at increased risk for ADRs. Pretreatment genotyping offers a proactive approach to identify these high-risk patients, administer an individualized dose, and minimize the risk of ADRs. In the field of oncology, the most well-studied gene-drug pairs for which pharmacogenetic dosing recommendations have been published to improve safety are DPYD-fluoropyrimidines, TPMT/NUDT15-thiopurines, and UGT1A1-irinotecan. Despite the presence of these guidelines, the scientific evidence showing the benefits of pharmacogenetic testing (e.g., improved safety and cost-effectiveness) and the development of efficient multi-gene genotyping panels, routine pretreatment testing for these gene-drug pairs has not been implemented widely in the clinic. Important considerations required for widespread clinical implementation include pharmacogenetic education of physicians, availability or allocation of institutional resources to build an efficient clinical infrastructure, international standardization of guidelines, uniform adoption of guidelines by regulatory agencies leading to genotyping requirements in drug labels, and development of cohesive reimbursement policies for pretreatment genotyping. Without clinical implementation, the potential of pharmacogenetics to improve patient safety remains unfulfilled.
引用
收藏
页码:137 / 151
页数:14
相关论文
共 50 条
  • [21] Costs and Length of Stay of Drug-Related Hospital Admissions in Cancer Patients
    Ko, Yu
    Gwee, Yong-Sheng
    Huang, Yu-Chu
    Chiang, Joen
    Chan, Alexandre
    CLINICAL THERAPEUTICS, 2014, 36 (04) : 588 - 592
  • [22] THE FINANCIAL IMPACT OF MEDICATION RECONCILIATION TO REDUCE DRUG-RELATED PROBLEMS
    Lin, Y. M.
    Tsai, S. C.
    Shiau, Y. F.
    Leu, W. J.
    Liu, H. P.
    VALUE IN HEALTH, 2010, 13 (03) : A90 - A90
  • [23] Evaluation of pharmacists’ interventions on drug-related problems and drug costs in patients with cancer pain
    Ping Zhang
    Dan Lv
    Jin Zhao
    Shusen Sun
    Ling Li
    Yun Liao
    International Journal of Clinical Pharmacy, 2021, 43 : 1274 - 1282
  • [24] Evaluation of pharmacists' interventions on drug-related problems and drug costs in patients with cancer pain
    Zhang, Ping
    Lv, Dan
    Zhao, Jin
    Sun, Shusen
    Li, Ling
    Liao, Yun
    INTERNATIONAL JOURNAL OF CLINICAL PHARMACY, 2021, 43 (05) : 1274 - 1282
  • [25] Drug transporter pharmacogenetics as a predictor of chemotherapy-induced toxicity in lung cancer patients
    Zair, Z.
    Singer, D.
    ANNALS OF ONCOLOGY, 2018, 29
  • [26] Drug-related problems in elderly patients with cancer receiving outpatient chemotherapy
    Ting, Yeoh Ting
    Yin, Tay Xin
    Si, Phebe
    Chew, Lita
    JOURNAL OF GERIATRIC ONCOLOGY, 2015, 6 (04) : 280 - 287
  • [27] Influence of chemotherapeutic drug-related gene polymorphisms on toxicity and survival of early breast cancer patients receiving adjuvant chemotherapy
    Ludovini, Vienna
    Antognelli, Cinzia
    Rulli, Antonio
    Foglietta, Jennifer
    Pistola, Lorenza
    Eliana, Rulli
    Floriani, Irene
    Nocentini, Giuseppe
    Tofanetti, Francesca Romana
    Piattoni, Simonetta
    Minenza, Elisa
    Talesa, Vincenzo Nicola
    Sidoni, Angelo
    Tonato, Maurizio
    Crino, Lucio
    Gori, Stefania
    BMC CANCER, 2017, 17
  • [28] Influence of chemotherapeutic drug-related gene polymorphisms on toxicity and survival of early breast cancer patients receiving adjuvant chemotherapy
    Vienna Ludovini
    Cinzia Antognelli
    Antonio Rulli
    Jennifer Foglietta
    Lorenza Pistola
    Rulli Eliana
    Irene Floriani
    Giuseppe Nocentini
    Francesca Romana Tofanetti
    Simonetta Piattoni
    Elisa Minenza
    Vincenzo Nicola Talesa
    Angelo Sidoni
    Maurizio Tonato
    Lucio Crinò
    Stefania Gori
    BMC Cancer, 17
  • [29] Drug-Related Genomics in Cancer and Immunological Diseases
    Wei, Ji-Fu
    Wang, Yong-Qing
    Luo, Huai-Rong
    INTERNATIONAL JOURNAL OF GENOMICS, 2014, 2014