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Oncologist. 2018 Aug;23(8):956-964. doi: 10.1634/theoncologist.2017-0599. Epub 2018 Apr 5.

Value of Supportive Care Pharmacogenomics in Oncology Practice.

Author information

1
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA Jai.Patel@carolinashealthcare.org.
2
NorthShore University Health System, Evanston, Illinois, USA.
3
The DeBartolo Family Personalized Medicine Institute, Moffitt Cancer Center, Tampa, Florida, USA.

Abstract

Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug response-otherwise known as pharmacogenomics-is well documented and directly influences an individual patient's response to antiemetics, opioids, neuromodulators, antidepressants, antifungals, and more. The growing body of pharmacogenomic data can now guide clinicians to select the safest and most effective supportive medications for an individual patient with cancer from the very first prescription. This review outlines a theoretical patient case and the implications of using pharmacogenetic test results to personalize supportive care throughout the cancer care continuum.

IMPLICATIONS FOR PRACTICE:

Integration of palliative medicine into the cancer care continuum has resulted in increased quality of life and survival for patients with many cancer types. However, suboptimal management of symptoms such as pain, neuropathy, depression, and nausea and vomiting continues to place a heavy burden on patients with cancer. As demonstrated in this theoretical case, pharmacogenomics can have a major effect on clinical response to medications used to treat these conditions. Recognizing the value of supportive care pharmacogenomics in oncology and application into routine practice offers an objective choice for the safest and most effective treatment compared with the traditional trial and error method.

KEYWORDS:

Cancer; Oncology; Pharmacogenetics; Pharmacogenomics; Supportive care; Symptom management

PMID:
29622698
PMCID:
PMC6156181
[Available on 2019-08-01]
DOI:
10.1634/theoncologist.2017-0599

Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

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