Claire Saadeh1, David Bright2, Danielle Rustem3. 1. Ferris State University College of Pharmacy, Department of Pharmacy Practice; Sparrow Health System Department of Pharmacy; and Herbert-Herman Cancer Center. clairesaadeh@ferris.edu. 2. Ferris State University College of Pharmacy, Department of Pharmaceutical Sciences. 3. Ferris State University College of Pharmacy, PharmD Candidate.
Abstract
The objective of this review is to provide an overview of the components, process and resources available to apply precision medicine strategies to drug therapy in cancer medicine, with an emphasis on oncology pharmacy practice. Precision medicine initiatives in oncology take into account individual variability in genes, environment and lifestyle factors. Genomic assays of patient tumors is now the standard of care in oncology and recommendations for targeted drug therapies are often formulated by interprofessional teams. Pharmacogenomics (PGx) is a component of precision medicine based on polymorphisms that impact medication selection and/or dosing. Several oncolytic agents used in the treatment of cancer and supportive care have pharmacogenomic- based dosing recommendations to minimize potential toxicities. Several resources are reviewed here to guide treatment options in oncology as they relate to somatic mutations and PGx. Examples include: OncoKB is a precision oncology knowledge base that offers evidence-based information for somatic mutations. The Clinical Pharmacogenetics Implementation Consortium provides PGx-based guidelines for several oncolytic therapies used to treat cancer and for supportive care. Pharmacists can be integral members of the interprofessional team in many practice settings in precision medicine. Involvement can include membership in molecular tumor boards, PGx dosing services and provide patient education. CONCLUSION: Precision medicine is a rapidly evolving field in oncology that requires an interprofessional approach of drug therapy experts.
The objective of this review is to provide an overview of the components, process and resources available to apply precision medicine strategies to drug therapy in cancer medicine, with an emphasis on oncology pharmacy practice. Precision medicine initiatives in oncology take into account individual variability in genes, environment and lifestyle factors. Genomic assays of patienttumors is now the standard of care in oncology and recommendations for targeted drug therapies are often formulated by interprofessional teams. Pharmacogenomics (PGx) is a component of precision medicine based on polymorphisms that impact medication selection and/or dosing. Several oncolytic agents used in the treatment of cancer and supportive care have pharmacogenomic- based dosing recommendations to minimize potential toxicities. Several resources are reviewed here to guide treatment options in oncology as they relate to somatic mutations and PGx. Examples include: OncoKB is a precision oncology knowledge base that offers evidence-based information for somatic mutations. The Clinical Pharmacogenetics Implementation Consortium provides PGx-based guidelines for several oncolytic therapies used to treat cancer and for supportive care. Pharmacists can be integral members of the interprofessional team in many practice settings in precision medicine. Involvement can include membership in molecular tumor boards, PGx dosing services and provide patient education. CONCLUSION: Precision medicine is a rapidly evolving field in oncology that requires an interprofessional approach of drug therapy experts.