Pharmacogenomics of Anticancer Agents: Implications for Clinical Pharmacy Practice

2007 ◽  
Vol 20 (3) ◽  
pp. 246-251 ◽  
Author(s):  
Jodi L. Grabinski
Keyword(s):  
Clinical Practice ◽  
Anticancer Agents ◽  
Genetic Information ◽  
Package Insert ◽  
Pharmacy Practice ◽  
Drug Metabolizing Enzymes ◽  
Metabolizing Enzymes ◽  
Predictors Of Response ◽  
The Us ◽  
Improving Patient Care

Hematology and oncology have been two of the leading areas in pharmacogenomics. The use of genetic information to guide therapy has been practiced for a number of years. The identification of polymorphisms within drug-metabolizing enzymes of anticancer agents such as 6-mercaptopurine and irinotecan has led to subsequent changes in package-insert labeling and tests approved by the US Food and Drug Administration to identify polymorphisms. Many studies within oncology are now conducting pharmacogenomic analyses in drug development to identify predictors of response and/or toxicity. For clinical pharmacists, knowledge in the area of pharmacogenomics and drug metabolism is important to understand and integrate pharmacogenomics into clinical practice. This article will review a number of different agents used in the realm of oncology and will identify how pharmacogenomics has or will potentially affect treatment decisions in the future with the goal of improving patient care and outcomes.

Pharmacogenetics, Drug-Metabolizing Enzymes, and Clinical Practice

2006 ◽  
Vol 58 (3) ◽  
pp. 521-590 ◽  
Author(s):  
Sharon J. Gardiner ◽  
Evan J. Begg
Keyword(s):  
Clinical Practice ◽  
Drug Metabolizing Enzymes ◽  
Metabolizing Enzymes

Pharmacogenomic Applications in Oncology

2012 ◽  
Vol 25 (4) ◽  
pp. 439-446 ◽  
Author(s):  
Christine M. Walko ◽  
Ogechi Ikediobi
Keyword(s):  
Clinical Practice ◽  
Therapeutic Index ◽  
Drug Metabolizing Enzymes ◽  
Interpatient Variability ◽  
Drug Selection ◽  
Low Loss ◽  
Narrow Therapeutic Index ◽  
Metabolizing Enzymes ◽  
Package Inserts ◽  
Prospective Trials

Oncology chemotherapeutics frequently exhibit a narrow therapeutic index, further complicated by the serious nature of dosing either too high (dangerous toxicities) or too low (loss of antitumor benefits). This underscores the need for optimal individualized drug selection and dosing, especially with agents that have wide interpatient variability. Pharmacogenomic assessment of drug metabolizing enzymes can improve the ability to optimally dose patients being treated with certain agents such as 6-mercaptopurine, irinotecan, tamoxifen, and flurouracil. Two of these agents (6-mercaptopurine and irinotecan) already have mention of pharmacogenomic testing in their FDA approved package inserts. Ongoing retrospective and prospective trials will help to further optimize the place in clinical practice for not only performing these pharmacogenomic assessments but, more importantly, how the results should be incorporated into therapy dosing decisions for patients.

scholarly journals Influence Factors of the Pharmacokinetics of Herbal Resourced Compounds in Clinical Practice

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Shi Sun ◽  
Yifang Wang ◽  
Ailing Wu ◽  
Zhen Ding ◽  
Xinguang Liu
Keyword(s):  
Drug Interaction ◽  
Clinical Practice ◽  
Influence Factors ◽  
Herbal Medicines ◽  
The Body ◽  
Drug Metabolizing Enzymes ◽  
The West ◽  
Metabolizing Enzymes ◽  
Potential Factors ◽  
Clinical Risks

Herbal medicines have been used to prevent and cure diseases in eastern countries for thousands of years. In recent decades, these phytotherapies are becoming more and more popular in the West. As being nature-derived is the essential attribute of herbal medicines, people believe that taking them for diseases treatment is safe enough and has no side-effects. However, the efficacy of herbal resourced compounds (HRC) depends on the multiple constituents absorbed in the body and their pharmacokinetics. Thus, many factors will influence the clinical practice of HRC, i.e., their absorption, distribution, metabolism, and excretion (ADME). Among these factors, herb-drug interaction has been widely discussed, as these compounds may share the same drug-metabolizing enzymes and drug transporters. Meanwhile there are many other potential factors that can also change the ADME of HRC, including herb pretreatment, herb-herb interactions, pathological status, gender, age of patient, and chemical and physical modification of certain ingredients. With the aim of ensuring the efficacy of HRC and minimizing their clinical risks, this review provides and discusses the influence factors and artificial improvement of the pharmacokinetics of HRC.

scholarly journals Pharmacogenetics of Carbamazepine and Valproate: Focus on Polymorphisms of Drug Metabolizing Enzymes and Transporters

2021 ◽  
Vol 14 (3) ◽  
pp. 204
Author(s):  
Teresa Iannaccone ◽  
Carmine Sellitto ◽  
Valentina Manzo ◽  
Francesca Colucci ◽  
Valentina Giudice ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Drug Response ◽  
Current Knowledge ◽  
Individual Variability ◽  
Mood Stabilizers ◽  
Drug Metabolizing Enzymes ◽  
Efficacy And Safety ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Metabolizing Enzymes ◽  
Drug Pharmacokinetics

Pharmacogenomics can identify polymorphisms in genes involved in drug pharmacokinetics and pharmacodynamics determining differences in efficacy and safety and causing inter-individual variability in drug response. Therefore, pharmacogenomics can help clinicians in optimizing therapy based on patient’s genotype, also in psychiatric and neurological settings. However, pharmacogenetic screenings for psychotropic drugs are not routinely employed in diagnosis and monitoring of patients treated with mood stabilizers, such as carbamazepine and valproate, because their benefit in clinical practice is still controversial. In this review, we summarize the current knowledge on pharmacogenetic biomarkers of these anticonvulsant drugs.

scholarly journals Tailoring Drug Therapy Based on Genotype

2012 ◽  
Vol 25 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Larisa H. Cavallari
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Genetic Information ◽  
Drug Targets ◽  
Drug Disposition ◽  
Warfarin Dose ◽  
Drug Metabolizing Enzymes ◽  
Metabolizing Enzymes ◽  
Immunodeficiency Virus

Polymorphisms in genes encoding drug metabolizing enzymes, drug transporters, and drug targets can influence drug effects and contribute to inter-individual differences in drug response. Genotype for drug metabolizing enzymes and drug transporters can influence drug disposition in the body (pharmacokinetics), whereas genotype for drug targets may influence sensitivity to a drug (pharmacodynamics). In some cases, response to a particular drug is contingent on genotype for both drug disposition and drug target proteins. For example, warfarin dose requirements are influenced by both cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase complex 1 (VKORC1) genotypes. The goal of pharmacogenetics is to maximize drug effectiveness while limiting drug toxicity, based on an individual's DNA. Over 80 drugs now contain genetic information in their FDA-approved labeling. In addition to influencing warfarin dose requirements, genotype contributes to the efficacy of clopidogrel in coronary artery disease, risk for hypersensitivity reactions to abacavir in the treatment of human immunodeficiency virus, risk for statin-induced myopathy, and responses to numerous other drugs. Genetic information is routinely integrated into decisions regarding cancer chemotherapy and treatment for human immunodeficiency virus. Clinical implementation of pharmacogenetics is becoming a reality in other therapeutic areas, such as for patients requiring dual antiplatelet therapy following coronary artery stent implantation. In the future, it is possible that individuals will be broadly genotyped so that genetic information can guide drug therapy decisions throughout their lifetime.

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