Pharmacogenetics and individualized medicine – bridging the gap between pharmacogenetic research and the patient

摘要

A considerable component of the variability seen in drug response or drug disposition has been explained by pharmacogenetic factors. Thus, diagnosing inherited variability in molecules involved in drug response may help to optimize drug therapy and provide more individualized treatment. However, despite the availability of a large amount of pharmacogenetic research data, there are still only a few examples of genotyping being incorporated into clinical drug therapy. In order to bridge the gap between pharmacogenetic research and clinical application, the unequivocal proof of the benefit of pharmacogenetic diagnostics in a certain drug therapy is warranted. But this is not all; there is a clear need for research results to be translated into clinically adoptable guidelines or, when this is not possible, more appropriately designed studies should be conducted with the aim of applying the data in the clinic. Furthermore, more education on pharmacogenetics and the genetic mechanisms underlying interindividual variability in disease susceptibility, treatment course and treatment response should be provided. As a third point, an infrastructure for genetic testing has to be established and this should not only include valid methods for genetic analyses, but especially the logistics of sample shipping, clear indications and instructions for blood sampling from patients, and valid interpretation and communication of the results. Thus, in order to routinely apply pharmacogenetic testing in drug therapy, several concrete steps have to be undertaken, in addition to the optimization of research studies.