Preemptive drug-gene testing could improve care
Targeted genomic testing can play an important role in drug prescribing practices. That's the conclusion of a new study by investigators from Mayo Clinic and Baylor College of Medicine.
Results of the "Right Drug, Right Dose, Right Time: Using Genomic Data to Individualize Treatment" (RIGHT 10K) study strongly suggest that preemptive testing could benefit nearly every patient — especially when the testing extends beyond DNA variants already known to influence drug metabolism.
"The right drug matched to a person's genetic makeup may maximize the drug's therapeutic benefit. But the wrong drug or dose may make a medication ineffective or even fatal," says Liewei Wang, M.D., Ph.D., director of the Pharmacogenomics Program at Mayo Clinic's Center for Individualized Medicine and the study's co-first author.
The RIGHT 10K investigators isolated DNA in stored samples from 10,077 long-term Mayo Clinic patients. Genes known to be involved in drug metabolism or transport were sequenced.
Targeted sequencing was used to capture not only common, known variants, but also more numerous but mostly uncharacterized variants that might impact drug prescribing practices. Results from 13 genes were placed into each patient's electronic health record along with an interpretative report and best practice alerts for 21 drug-gene pairs.
"We found that nearly all of the participants could have benefitted from receiving preemptive pharmacogenomics data and the interpretation report, depending on the drugs their clinicians might prescribe," Dr. Wang says.
The researchers note that several of the variants now considered rare will likely be recognized eventually as more common.
"Pharmacogenomics will extend well beyond genotypes for the small number of genes included in the 21 drug-gene pair alerts we studied," Dr. Wang says. "Pharmacogenomics promises to become a standard component of clinical practice that will help the health care team optimize pharmacotherapies for all patients."