HARMACOGENOMICS
One of the most important components of personalized medicine is pharmacogenomics, the study of genetic variations that influence individual response to drugs. Enzymes responsible for drug metabolism and proteins that determine the cellular response to drugs (receptors) are encoded by genes, and can therefore be variable in expression, activity level and function when genetic variations are present. Knowing whether a patient carries any of these variations may help health care professionals individualize drug therapy, decrease the number of adverse drug reactions and increase the effectiveness of drugs. Pharmacogenomics has been characterized as "getting the right dose of the right drug to the right patient at the right time."
BACKGROUND
Chemotherapeutic agents are considered one of the most dangerous drug categories. Currently, drugs are delivered based on patients' body surface area or BSA. This approach, however, does not take into account a patient's variation in drug metabolism, and may cause serious adverse drug reactions.
Accredited laboratories understand the complexity of chemotherapy, the variety of available medications, and the challenges providers and patients are facing.
Our oncological pharmacogenetic testing (PGT) panel is designed to help physicians better understand a patient's ability to metabolize medications commonly used in cancer treatments.
PGT results help a physician practice personalized medicine the right medication at the right dosage to the right patient, and achieve the best treatment outcome. PGT also helps boost medication adherence, reduce adverse drug reactions, avoid drug-drug interactions, reduce medical costs, and most importantly, save precious drug trial-and-error time.
ONCOLOGICAL PANEL
PGT panels can help physicians decide the best course of treatment, for cancer itself and symptoms associated with cancer treatments, such as pain, nausea, and loss of appetite.
CANDIDATES FOR ONCOLOGY PGT PANEL
· Multiple organ system issues
· Multiple medications
· Serious adverse drug reaction
CYTOCHROME P450 ENZYMES
Cytochrome P450 enzymes (CYPs), expressed predominately in the liver, are responsible for metabolizing about 75% of all medications. PGT detects single nucleotide polymorphism (SNPs) in five genes for these enzymes - CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5.
Lab results are reported as poor metabolizer (PM), intermediate metabolizer (IM), extensive metabolizer (EM), and ultra-rapid metabolizer (UM) for their varying degrees of drug metabolizing ability. Medications can be adjusted to achieve the best treatment results.
TYPICAL ONCOLOGY PANEL
Gene: CYP2C9
Clinical Use:
Anti-cancer drug
cyclophosphamide
Anti-nausea and Appetite stimulant
dronabinol(tetrahydrocannabinol)
Gene: CYP2C19
Clinical Use:
Anti-cancer drug
Tamoxifen
Anti-nausea and Appetite stimulant
dronabinol(tetrahydrocannabinol)
Gene: CYP2D6
Clinical Use:
Anti-stimulant
mirtazapine
Anti-nausea drugs
metoclopramide, ondansetron, prochlorperazine
Gene: CYP3A4, CYP3A5
Clinical Use:
Anti-cancer drugs
docetaxel, imatinib, etoposide, ifofamide, irinotecan, paclitaxel,
tamoxifen, topotecan, vinblastine, vincristine, vinorelbine
Anti-nausea drugs
dronabinol, ondansetron, granisetron, prochlorperazine
Appetite stimulants
mirtazapine, dronabinol, dexamethasone, prednisone
methylprednisolone, megestrol acetate
Since this is relatively new testing outside of environments such as the Mayo Clinic and Vanderbilt, patients are encouraged to ask their personal physicians to request these tests.
