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Pharmacogenomics: When medicine gets personal
How is pharmacogenomics used today?
A few tests are now available that can help predict whether individuals with cancer or other diseases are likely to have good responses — or bad reactions — to certain medications. One such test is the cytochrome P450 genotyping test. The test looks at a group of enzymes known as cytochrome P450 (CYP450) enzymes, which are responsible for metabolizing — breaking down and eliminating — more than 30 types of medications, such as antidepressants, proton pump inhibitors, and anticoagulants such as warfarin.
Some people, because of their genetic makeup, aren't able to break down these medications fast enough. The medications can then build up in the body and cause severe side effects. Conversely, some people break down these medications too quickly — before they have a chance to work. The CYP450 test can identify people with these genetic variations so that doctors can make more-informed prescribing decisions, reducing the risk of adverse events and increasing the likelihood of treatment success.
What are some of the barriers to pharmacogenomics?
The field of pharmacogenomics is still in its early stages. It's possible that millions of genetic variations may exist, and identifying them all could take many years — if it's even possible. In addition, how you respond to a medication may not be determined by just one gene but rather by many genes interacting with each other. Combing through this complicated genetic map is expensive and time-consuming. As a result, it may be some time before pharmacogenomics is a routine part of medicine.
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- Pharmacogenomics. Human Genome Project. http://www.ornl.gov/sci/techresources/Human_Genome/medicine/pharma.shtml. Accessed April 16, 2010.
- Roden DM, et al. Pharmacogenomics: Challenges and opportunities. Annals of Internal Medicine. 2006;145:749.
- Lanfear DE, et al. Pharmacogenetics: Using DNA to optimize drug therapy. American Family Physician. 2007;76:1179.
- Campos-Outcalt D. Personalized medicine: The promise, the reality. The Journal of Family Practice. 2007;56:621.
- Genomics 101: A primer. http://www.ornl.gov/sci/techresources/Human_Genome/publicat/primer2001/1.shtml. Human Genome Project. Accessed May 4, 2010.
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