An interesting article on applied pharmacogenetics in support of cancer treatment describes cancer-related symptoms, including depression, anxiety, nausea, vomiting, and pain, that negatively impact patients’ functional status and quality of life. Pain occurs in approximately two-thirds of cancer patients, with more than one-third experiencing moderate to severe pain [1]. Depression affects up to a quarter of patients, especially in the first year after diagnosis and during treatment [2].
Early management of cancer-related symptoms improves quality of life, treatment adherence, and possibly survival [3]. However, effective treatment of these symptoms remains a challenge due to inter-individual variability in response to supportive medications, which can be partially attributed to genetic variations that affect the pharmacology of medications.
Personalized supportive care using genetics is a strategy to move away from the traditional trial-and-error approach, in the search for the drug that produces the best effect and avoids adverse reactions. Pharmacogenetics studies the impact of genetic variations on drug response. Data suggest that 99% of patients carry at least one major clinically actionable pharmacogenetic variant for which guidelines are available [4,5].
The US FDA Table of Pharmacogenetic Associations and the Clinical Pharmacogenetics Implementation Consortium (CPIC) peer-reviewed clinical guidelines provide guidance on how to translate pharmacogenetics results into actionable prescribing decisions for many drugs, including opioids, anti-inflammatory drugs, non-steroidal drugs (NSAIDs), antidepressants and antiemetics [6-8]. For example, slow and ultra-rapid metabolizers of the CYP2D6 gene are at risk for inadequate analgesia or toxicity with certain opioids, particularly codeine and tramadol, but also, to a lesser extent, hydrocodone [9].
If you want to know more about studies carried out and the full content, access the article here.
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