Pharmacogenomics: Driving Personalized Medicine

摘要

Personalized medicine tailors therapies, disease prevention, and health maintenance to the indi-vidual, with pharmacogenomics serving as a key tool to improve outcomes and prevent adverse effects. Advances in genomics have transformed pharmacogenetics, tradi-tionally focused on single gene-drug pairs, into pharmaco-genomics, encompassing all "-omics" fields (e.g., proteomics, transcriptomics, metabolomics, and metagenomics). This review summarizes basic genomics principles relevant to translation into therapies, assessing pharmacogenomics' central role in converging diverse elements of personal-ized medicine. We discuss genetic variations in pharma-cogenes (drug-metabolizing enzymes, drug transporters, and receptors), their clinical relevance as biomarkers, and the legacy of decades of research in pharmacoge-netics. All types of therapies, including proteins, nucleic acids, viruses, cells, genes, and irradiation, can benefit from genomics, expanding the role of pharmacogenom-ics across medicine. Food and Drug Administration ap-provals of personalized therapeutics involving biomarkers increase rapidly, demonstrating the growing impact of pharmacogenomics. A beacon for all therapeutic ap-proaches, molecularly targeted cancer therapies high-light trends in drug discovery and clinical applications. To account for human complexity, multicomponent bio-marker panels encompassing genetic, personal, and envi-ronmental factors can guide diagnosis and therapies, increasingly involving artificial intelligence to cope with extreme data complexities. However, clinical application encounters substantial hurdles, such as unknown valid-ity across ethnic groups, underlying bias in health care, and real-world validation. This review address the underlying science and technologies germane to phar-macogenomics and personalized medicine, integrated with economic, ethical, and regulatory issues, provid-ing insights into the current status and future direction of health care.Significance Statement--Personalized medicine aims to optimize health care for the individual pa-tients with use of predictive biomarkers to improve out-comes and prevent adverse effects. Pharmacogenomics drives biomarker discovery and guides the develop-ment of targeted therapeutics. This review addresses basic principles and current trends in pharmacoge-nomics, with large-scale data repositories accelerating medical advances. The impact of pharmacogenomics is discussed, along with hurdles impeding broad clini-cal implementation, in the context of clinical care, ethics, economics, and regulatory affairs.