Pharmacogenomics – Cancer Genomics

 by Bianka Anszczak

Since the sequencing of the human genome in 2003 and the launch of the NHS 100 000 Genomes Project in 2012, healthcare has begun to move away from a ‘one size fits all’ approach to patients and their treatment. Pharmacogenomics is leading the way in medicine optimisation, by providing personalised medicine for patients.

Evidence shows that the use of PGx can improve patient safety by ensuring they receive the most suitable treatment from the very beginning. This increases therapeutic response and reduces the risk of adverse reactions. Moreover, it also benefits the NHS, as it can reduce medicines waste as well as it being a more efficient use of clinician’s time.

The benefits provided by pharmacogenetics can be seen within cancer care. Cancer is ultimately a genetic disease; it is caused when mutations in the genome cause cells to divide uncontrollably leading to the formation of a tumour. Using pharmacogenomics, more specifically, cancer genomics, healthcare professionals can use medicines to target the root of the problem rather than attempt to fix what has already gone wrong. In addition, thanks to the whole genome being sequenced, it enables us to account for other genetic risk factors.

Currently in cancer research there are many issues:

1.   Late diagnosis due to a lack of testing and screening.

2.   Flawed treatment as patients’ responses to medications are unpredictable.

3.   Difficulty in characterising the cancer as it is constantly evolving.

But pharmacogenomics addresses all these problems.

When treating cancer, scientists are dealing with two genomes. The cancer genome and the genome of the patient. Each play a role in determining which drugs a patient will respond to best, as well as which patients are more susceptible to specific types of cancers and how they can therefore be prevented.

Today, scientists can do this by taking a sample of a tumour and diagnosing it through sequencing and comparing it with others, allowing each tumour to be regarded as a unique mutation. Before genomics, clinical trials were based on the organ the mutation was found in whereas now, they are based of where/ what the altered genes are.

Despite pharmacogenomics being incredibly beneficial as it can be used to predict the benefits of a certain treatment, it must be noted that at the moment we cannot grantee the benefits. However, development of new technologies to pick up on certain cancers in the blood, makes the future of genomic testing bright.

Pharmacists will play a vital role in implementing personalised optimisation of medicines and have the potential to provide new testing services to help with early diagnosis of a disease. An article in The Chemist+Druggist acknowledged how Wales aims to introduce pharmacogenomics in pharmacies by 2025. Of course, uptake, equity of access, ethical, legal, and social issues could prove to be a problem. But how far would you go to get the right medicine for you?