Translating pharmacogenomics: challenges on the road to the clinic

Abstract

Pharmacogenomics is one of the first clinical applications of the postgenomic era. It promises personalized medicine rather than the established "one size fits all" approach to drugs and dosages. The expected reduction in trial and error should ultimately lead to more efficient and safer drug therapy. In recent years, commercially available pharmacogenomic tests have been approved by the Food and Drug Administration (FDA), but their application in patient care remains very limited. More generally, the implementation of pharmacogenomics in routine clinical practice presents significant challenges. This article presents specific clinical examples of such challenges and discusses how obstacles to implementation of pharmacogenomic testing can be addressed.

Figure 1. Consecutive Phases and Associated Challenges on the Road to Clinical Implementation of Pharmacogenomics

Figure 2. The Use of the Calvert Formula in Clinical Trials from 1989 to 1998

A PubMed search for the dosing of carboplatin in clinical trials was performed for the period 1989–1998. For each year the first ten results of PubMed were screened for the use of the Calvert formula. Bars represent the percentage of results in which the Calvert formula was used to dose carboplatin (A), the Calvert formula was not used (B), or no dosing information could be retrieved electronically (C).