Pharmacogenomics, the Foundation of Precision Medicine
Not everyone responds to the same medication in the same way. Medication effectiveness and side effects vary by individual, influenced by genetics, health history, age, and lifestyle.
Pharmacogenomics is a new field of science that is growing rapidly due to its ability to minimize trial-and-error dosing and improve treatment outcomes. It combines the study of drugs (pharmacology) with the study of genes (genomics). This is a powerful combination: It empowers scientists to predict how a person’s genes may impact how they may respond to a medication and allows their physician to prescribe medication best suited to that individual.
Pharmacogenomics aims to tailor drugs and dosages to individual patients for maximum efficacy and minimal side effects, known as precision medicine. Currently, precision medicine is still in its relatively early stages, and it’s only available for certain conditions. As research advances, however, pharmacogenomics has the potential to transform medical care.
How Can Someone’s Genes Alter the Way They Respond to a Drug?
Many drugs work by attaching themselves to receptors on the surface of cells. The types of receptors are determined by a person’s DNA, and different receptors respond differently to medications. A drug might be highly effective for a person with one type of receptor while not as effective for someone with a different type of receptor. By learning what kind of receptors a patient has, doctors can determine the most suitable drug and dosage for that patient.
Sometimes, a person’s DNA may make them a strong candidate for a certain kind of drug; other times, a person’s DNA shows that they won’t respond well to a particular drug or may need a lower dosage of it to minimize side effects. Instead of using one drug to treat everyone with a certain condition, doctors can tailor the medication and dosage to the individual.
How Does a Patient Get Genetic Testing for Precision Medicine?
Studies have revealed that 98% of people may have a genomic variant that may affect how they respond to medications. To learn if they do, a patient can take a genetic test that looks for a gene or several genes that may affect which medication is best for them. This can be done with a blood sample or a cheek swab.
Genomic testing is usually performed when a person receives a diagnosis for the first time, when a medication fails to work, or when adverse effects interfere with treatment.
What is the Current State of Pharmacogenomics for Serious and Complex Diseases?
At this point, the use of pharmacogenomics is somewhat limited. First, tests can be expensive and not widely available. Second, pharmacogenomics has only been approved to treat several health conditions. Some conditions that have benefited from advances in pharmacogenomics include:
• Certain cancers, including breast cancer, colon cancer, and acute lymphoblastic leukemia (ALL)
• Depression
• HIV
• Heart disease
• High cholesterol
Clinical trials reveal new uses for pharmacogenomics each year, and its availability and applicability is expected to steadily increase to include new conditions and diseases.
What is the Hope for the Future of Pharmacogenomics?
We’re truly on the brink of individualized medicine. As medicine becomes increasingly personalized, doctors will be able to better predict which drug suits each person best. Pharmacogenomics work alongside related fields in medicine, including epigenetics (which studies how cells affect gene activity), microbiome studies (which examine how microorganisms within our bodies affect our health), and nutrigenomics (which studies how nutrient affects genetic makeup). Together, these studies will allow doctors to gain a greater understanding of how to match the right drug to the right person. This may lead to better health outcomes and fewer adverse side effects for patients, creating hope for a happier, healthier tomorrow.
