1. Pharmacogenomics

Category Archives: Pharmacogenomics

Wong – Pharmacogenomics and Pharmacometabolomics for Personalized Medicine – Video

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Wong - Pharmacogenomics and Pharmacometabolomics for Personalized Medicine
Watch on LabRoots at: http://labroots.com/user/webinars/details/id/269 Pharmcogenomics (PGx) is the 2nd potential clinical application of genomic medicine, preceded by genomic application for...

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Wong - Pharmacogenomics and Pharmacometabolomics for Personalized Medicine - Video

Improving treatment for depression in the young – Washington Times

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ANALYSIS/OPINION:

I watched my son battle through the darkest depths of depression. My familys struggle to find a treatment that would work was one of the most painful experiences any mother could endure. Depression is a wide-ranging problem that demands bold and innovative solutions. But currently, the Food and Drug Administration is taking action to shut the door when it comes to innovative genetic testing that identifies treatments for depression.

When it comes to mental health Ive learned that the status quo often means a frustrating trial-and-error process of medication selection. Advances in genetics are changing that. Innovative genetic testing is now being used to personalize the treatment of depression and mental illness. This testing helped save my 13-year-old sons life.

When my sons adolescent angst and ADHD intensified over the years into a far more serious struggle with the depths of depression, we pursued a series of treatments. We tried regular therapy and doctors appointments, psychiatry, and what felt like endless trials of a colorful assortment of antidepressants and mood stabilizers.

Nothing seemed to impact on my sons condition and well-being. Still, there was little substantive discussion about taking a fresh approach to his medication regimen. At one point, I begged his physician to consider alternatives. It was then that she suggested a pharmacogenomic test that measures how a persons genetic variations influence their response to different medications.

The test results immediately highlighted alarming issues in my sons treatment regimen and the dosages he was prescribed. Together with his doctor, we made the decision to wean him off several of his medications and begin an alternative protocol that was better suited to his DNA. The test helped guide what drugs and dosages to try.

As a parent who had felt a loss of control, this test gave a newfound sense of control, understanding and hope. The new course of treatment has had a meaningful and enduring impact on my son and the results were evident within months.

Hindsight is always 20/20 but I wonder if some of the trial and error in his treatment was avoidable. Innovations like pharmacogenomic tests should play an important role in improving depression treatment and helping patients like my son get better.

It is therefore deeply concerning that the Food and Drug Administration is taking actions that restrict the use of pharmacogenomic testing. While a level of caution is understandable, it is striking that a regulator would make such a far-reaching move without engaging key stakeholders, including families like mine, who can speak to the life-changing benefits of these tests. Now more than ever, we need advances in technology and personalized medicine to achieve better patient outcomes in depression. We need the government to be part of the solution, not a barrier to progress.

Corey Welsh is a health care industry professional, mental health advocate, and the proud mom of two children. She resides in Chicago, Illinois.

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Improving treatment for depression in the young - Washington Times

Pharmacogenomics – Department of Psychiatry and Psychology …

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The primary objective of the clinical research of pharmacogenomics is to better understand genetic variability as it relates to antidepressant response. The team is involved in both psychiatric pharmacogenomics and pharmacogenomic testing for algorithm research.

Induced pluripotent stem (iPS) cell research. Yuan Ji, Ph.D., leads this study with the PGRN team, researching iPS cells in depressed patients treated with SSRIs. The team has partnered with Timothy J. Nelson, M.D., Ph.D., and colleagues at the University of Minnesota and the Salk Institute for Biological Studies to study a subset of patients who have been in the PGRN SSRI study.

First reported in 2007, iPS cells accomplish two important tasks. First, they convert adult skin cells into stem cells (cells capable of growing into many cell types). Second, these cells can be differentiated into neurons or other mature cell types. This technology provides the means to reprogram patients' skin cells into their own neurons, theoretically allowing an understanding of either an individual's response to treatment or how to engineer a personalized plan.

The team has completed numerous other projects, including a pharmacometabolomics study of escitalopram and citalopram response. Additional analyses are underway with colleagues at the University of North Carolina; the University of California, Davis; and the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass.

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Pharmacogenomics – Official Site

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Pharmacogenomics - Official Site

FAQ About Pharmacogenomics – Genome.gov

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Frequently Asked Questions About Pharmacogenomics

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Pharmacogenomics uses information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person. This new field combines the science of how drugs work, called pharmacology, with the science of the human genome, called genomics.

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Until recently, drugs have been developed with the idea that each drug works pretty much the same in everybody. But genomic research has changed that "one size fits all" approach and opened the door to more personalized approaches to using and developing drugs.

Depending on your genetic makeup, some drugs may work more or less effectively for you than they do in other people. Likewise, some drugs may produce more or fewer side effects in you than in someone else. In the near future, doctors will be able to routinely use information about your genetic makeup to choose those drugs and drug doses that offer the greatest chance of helping you.

Pharmacogenomics may also help to save you time and money. By using information about your genetic makeup, doctors soon may be able to avoid the trial-and-error approach of giving you various drugs that are not likely to work for you until they find the right one. Using pharmacogenomics, the "best-fit" drug to help you can be chosen from the beginning.

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Doctors are starting to use pharmacogenomic information to prescribe drugs, but such tests are routine for only a few health problems. However, given the field's rapid growth, pharmacogenomics is soon expected to lead to better ways of using drugs to manage heart disease, cancer, asthma, depression and many other common diseases.

One current use of pharmacogenomics involves people infected with the human immunodeficiency virus (HIV). Before prescribing the antiviral drug abacavir (Ziagen), doctors now routinely test HIV-infected patients for a genetic variant that makes them more likely to have a bad reaction to the drug.

Another example is the breast cancer drug trastuzumab (Herceptin). This therapy works only for women whose tumors have a particular genetic profile that leads to overproduction of a protein called HER2.

The U.S. Food and Drug Administration (FDA) also recommends genetic testing before giving the chemotherapy drug mercaptopurine (Purinethol) to patients with acute lymphoblastic leukemia. Some people have a genetic variant that interferes with their ability to process the drug. This processing problem can cause severe side effects and increase risk of infection, unless the standard dose is adjusted according to the patient's genetic makeup.

The FDA also advises doctors to test colon cancer patients for certain genetic variants before administering irinotecan (Camptosar), which is part of a combination chemotherapy regimen. The reasoning is that patients with one particular variant may not be able to clear the drug from their bodies as quickly as others, resulting in severe diarrhea and increased infection risk. Such patients may need to receive lower doses of the drug.

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Much research is underway to understand how genomic information can be used to develop more personalized and cost-effective strategies for using drugs to improve human health.

In 2007, the FDA revised the label on the common blood-thinning drug warfarin (Coumadin) to explain that a person's genetic makeup might influence response to the drug. Some doctors have since begun using genetic information to adjust warfarin dosage. Still, more research is needed to conclusively determine whether warfarin dosing that includes genetic information is better than the current trial-and-error approach.

The FDA also is considering genetic testing for another blood-thinner, clopidogrel bisulfate (Plavix), used to prevent dangerous blood clots. Researchers have found that Plavix may not work well in people with a certain genetic variant.

Cancer is another very active area of pharmacogenomic research. Studies have found that the chemotherapy drugs, gefitinib (Iressa) and erlotinib (Tarceva), work much better in lung cancer patients whose tumors have a certain genetic change. On the other hand, research has shown that the chemotherapy drugs cetuximab (Erbitux) and panitumumab (Vecitibix) do not work very well in the 40 percent of colon cancer patients whose tumors have a particular genetic change.

Pharmacogenomics may also help to quickly identify the best drugs to treat people with certain mental health disorders. For example, while some patients with depression respond to the first drug they are given, many do not, and doctors have to try another drug. Because each drug takes weeks to take its full effect, patients' depression may grow worse during the time spent searching for a drug that helps.

Recently, researchers identified genetic variations that influence the response of depressed people to citalopram (Celexa), which belongs to a widely used class of antidepressant drugs called selective serotonin re-uptake inhibitors (SSRIs). Clinical trials are now underway to learn whether genetic tests that predict SSRI response can improve patients' outcomes.

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Yes. Besides improving the ways in which existing drugs are used, genome research will lead to the development of better drugs. The goal is to produce new drugs that are highly effective and do not cause serious side effects.

Until recently, drug developers usually used an approach that involved screening for chemicals with broad action against a disease. Researchers are now using genomic information to find or design drugs aimed at subgroups of patients with specific genetic profiles. In addition, researchers are using pharmacogenomic tools to search for drugs that target specific molecular and cellular pathways involved in disease.

Pharmacogenomics may also breathe new life into some drugs that were abandoned during the development process. For example, development of the beta-blocker drug bucindolol (Gencaro) was stopped after two other beta-blocker drugs won FDA approval to treat heart failure. But interest in Gencaro revived after tests showed that the drug worked well in patients with two genetic variants that regulate heart function. If Gencaro is approved by the FDA, it could become the first new heart drug to require a genetic test before prescription.

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Last Updated: February 14, 2014

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FAQ About Pharmacogenomics - Genome.gov

Pharmacogenomics Program Mayo Clinic Center for …

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Getting you the right drug at the right dose at the right time is the goal of pharmacogenomics, which involves studying how your specific DNA sequence influences your response to medications.

The drugs available today to treat cancer, heart disease and other conditions are powerful agents that work as intended in most patients. Yet, in some people, a particular drug at the standard dose might not work well enough or may even trigger a serious adverse reaction. The reasons for this lie in your genes.

By using your unique genetic makeup as a factor when prescribing a drug for you, your doctor can maximize treatment effectiveness while avoiding potentially life-threatening side effects.

Pharmacogenomics can help us answer a broad range of questions, such as:

The BEAUTY study is performing whole-genome sequencing before and after neoadjuvant therapy (drug therapy before surgery) in women newly diagnosed with breast cancer.

Pharmacogenomics Program researchers are then comparing the tumor genome before and after neoadjuvant therapy against the patient's germline genome the sequence of DNA in normal, noncancerous tissue in order to match the genomic response to therapy.

With this study, we will be able to identify the best treatment options based upon the molecular response to therapy. We are also developing mouse "avatars" with the patient tumors so that we can find new and novel treatment options in the laboratory.

The PROMOTE study takes an approach similar to the BEAUTY study, but in prostate cancer. The Pharmacogenomics Program hopes to elucidate the DNA sequences associated with response to therapy in order to identify new treatment options for patients with advanced prostate cancer that has resisted all conventional therapies.

This study also includes groundbreaking work with mouse avatars, again to identify new and novel treatment options.

Patients with coronary artery disease often come into the emergency room requiring placement of one or more stents. In the TAILOR-PCI study, we are determining the specific DNA variant that might indicate whether the patient should receive the anticoagulant drug clopidogrel or an alternative drug, a question that has vexed cardiologists for years.

More generally, researchers have identified dozens of DNA variants that indicate which drug or how much drug should be prescribed. Most electronic medical record systems are not equipped to alert the pharmacist or physician to these drug-gene interactions.

The RIGHT study is building the necessary infrastructure to trigger alerts to physicians in the drug prescription process so that patients get the right drug at the right time in the right amount.

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Pharmacogenomics Program Mayo Clinic Center for ...

Stanford BMI 224 Final Project – Dexamethasone and ABCB1 Pharmacogenomics – Video

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Stanford BMI 224 Final Project - Dexamethasone and ABCB1 Pharmacogenomics
This video is my final project for Stanford Biomedical Informatics 224, winter 2014 quarter, taught by Dr Russ Altman and TA #39;d by Helio Costa. The presentati...

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Stanford BMI 224 Final Project - Dexamethasone and ABCB1 Pharmacogenomics - Video


  1. Pharmacogenomics