title: An update on ethnic differences in drug metabolism and toxicity from anti-cancer drugs.
abstract: BACKGROUND
  Based on recent emerging evidence of inter-ethnic differences in drug response and toxicity, ethnic diversity in pharmacokinetics, pharmacogenomics and clinical outcomes are being increasingly investigated. Ultimately, this will promote improved understanding of inter-individual differences in the pharmacokinetics and tolerance of cytotoxic drugs.
  
  
  METHODS
  This article reviews potential explanations for the observed ethnic differences in treatment outcomes and provides clinical data to support this concept. A literature search was implemented on PubMed and PharmGKB to investigate the areas of ethnic differences in pharmacogenomics, pharmacogenetics and clinical outcomes of cancer therapies.
  
  
  CONCLUSIONS
  There has been a relative paucity of clinical evidence linking genetic polymorphisms of genes encoding drug-metabolizing enzymes to the pharmacokinetics, pharmacodynamics and tolerance of anti-cancer drugs. Future research should focus on studies using large sample sizes, in the hope that they will provide results of high clinical significance. Due to the potential for ethnic differences to impact on both toxicities and benefits of systemic cancer therapies, the development of new therapeutic agents should include patients from diverse geographical ancestries in each phase of drug development.
authors.affiliation: The University of Sydney, Concord Repatriation General Hospital, Sydney Cancer Centre, Concord, NSW, Sydney, Australia.
authors.forename: Viet Hong
authors.initials: VH
authors.lastname: Phan
authors.forename: Cindy
authors.initials: C
authors.lastname: Tan
authors.forename: Anneliese
authors.initials: A
authors.lastname: Rittau
authors.forename: Hongmei
authors.initials: H
authors.lastname: Xu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McLachlan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Clarke
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000378:metabolism* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D008658:Inactivation, Metabolic / Q000208:ethnology / Q000235:genetics*; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D057285:Precision Medicine; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004364:Pharmaceutical Preparations