Pharmacogenomic potential in advanced cancer patients

Dan Nichols; Susanne Arnold; Heidi L Weiss; Jianrong Wu; Eric B Durbin; Rachel Miller; Jill Kolesar

doi:10.1093/ajhp/zxy079

Back

Pharmacogenomic potential in advanced cancer patients

Journal article

Open access

Peer reviewed

Pharmacogenomic potential in advanced cancer patients

Dan Nichols, Susanne Arnold, Heidi L Weiss, Jianrong Wu, Eric B Durbin, Rachel Miller and Jill Kolesar

American journal of health-system pharmacy, Vol.76(7), pp.415-423

03/19/2019

DOI: 10.1093/ajhp/zxy079

PMCID: PMC7936720

PMID: 31361818

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936720View

Published (Version of record) Open Access

Abstract

The prevalence of pharmacogenetically actionable medications in advanced cancer patients whose therapy may be optimized with genotype data was determined. Patients enrolled in our institutional molecular tumor board observational cohort were included in this study. Collected data included demographics, type(s) of cancer, and outpatient medications. Medications were classified as "pharmacogenetically actionable" if there are Clinical Pharmacogenetics Implementation Consortium (CPIC) therapeutic recommendations for that medication based on the presence of germline variations. The prevalence of pharmacogenetically actionable medications in the study population was determined, and the frequency of opportunities for pharmacogenetic prescribing and adverse event (AE) mitigation were estimated. In a cohort of 193 patients with advanced cancer, 65% of patients were taking a pharmacogenetically actionable medication. Approximately 10% of the outpatient medications taken by the study population had a pharmacogenetic association. The most common pharmacogenetically actionable medications being used were ondansetron (47%), capecitabine (10%), and sertraline (7%). Using published genetic variation frequencies and AE risk, we conservatively estimated that 7.1% of cancer patients would be eligible for genetic-based medication adjustment, and 101 AEs would be prevented in 10,000 patients genotyped. Medications with pharmacogenetic associations are used commonly in the advanced cancer patient population. This widespread exposure supports the implementation of prospective genotyping in the treatment of these high-risk patients.

Aged

Antineoplastic Agents - pharmacology

Antineoplastic Agents - therapeutic use

Biomarkers, Tumor - antagonists & inhibitors

Biomarkers, Tumor - genetics

Capecitabine - pharmacology

Capecitabine - therapeutic use

Drug Prescriptions - statistics & numerical data

Female

Humans

Male

Middle Aged

Neoplasms - drug therapy

Neoplasms - genetics

Neoplasms - pathology

Ondansetron - pharmacology

Ondansetron - therapeutic use

Pharmacogenomic Testing

Pharmacogenomic Variants

Precision Medicine - statistics & numerical data

Prospective Studies

Retrospective Studies

Sertraline - pharmacology

Sertraline - therapeutic use

Details

Title: Subtitle: Pharmacogenomic potential in advanced cancer patients
Creators: Dan Nichols - University of Kentucky HealthCare
Susanne Arnold - University of Kentucky
Heidi L Weiss - University of Kentucky
Jianrong Wu - University of Kentucky
Eric B Durbin - University of Kentucky
Rachel Miller - University of Kentucky
Jill Kolesar - University of Kentucky
Resource Type: Journal article
Publication Details: American journal of health-system pharmacy, Vol.76(7), pp.415-423
Publisher: Oxford University Press (OUP)
DOI: 10.1093/ajhp/zxy079
PMID: 31361818
PMCID: PMC7936720
ISSN: 1079-2082
eISSN: 1535-2900
Grant note: P30 CA177558 / NCI NIH HHS
Language: English
Date published: 03/19/2019
Academic Unit: Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
Record Identifier: 9984695802302771

Metrics

1 Record Views

7 Times Cited - Web of Science

See more details