title: Pharmacogenetics in clinical practice: how far have we come and where are we going?
abstract: Recent years have seen great advances in our understanding of genetic contributors to drug response. Drug discovery and development around targeted genetic (somatic) mutations has led to a number of new drugs with genetic indications, particularly for the treatment of cancers. Our knowledge of genetic contributors to variable drug response for existing drugs has also expanded dramatically, such that the evidence now supports clinical use of genetic data to guide treatment in some situations, and across a variety of therapeutic areas. Clinical implementation of pharmacogenetics has seen substantial growth in recent years and groups are working to identify the barriers and best practices for pharmacogenetic-guided treatment. The advances and challenges in these areas are described and predictions about future use of genetics in drug therapy are discussed.
authors: Department of Pharmacotherapy & Translational Research & Center for Pharmacogenomics, University of Florida, PO Box 100486, Gainesville, FL 32610-0486, USA. johnson@cop.ufl.edu
authors: Julie A
authors: JA
authors: Johnson
mesh_terms: D055808:Drug Discovery / Q000379:methods; D006801:Humans; D009154:Mutation; D009369:Neoplasms / Q000188:drug therapy / Q000235:genetics; D010597:Pharmacogenetics / Q000379:methods*
references: Nat Genet. 2005 Feb;37(2):161-5
references: 15654334
references: N Engl J Med. 2008 Feb 7;358(6):568-79
references: 18256392
references: Pharmacogenomics. 2010 Apr;11(4):507-12
references: 20350131
references: Clin Pharmacol Ther. 2012 Jul;92(1):112-7
references: 22617227
references: HIV Med. 2008 Oct;9(8):563-608
references: 18826546
references: Lancet Oncol. 2010 Jun;11(6):507-9
references: 20413348
references: Clin Pharmacol Ther. 2012 Mar;91(3):450-8
references: 22278335
references: Per Med. 2012 Jul;9(5):497-506
references: 29768769
references: Clin Pharmacol Ther. 2012 Oct;92(4):437-9
references: 22910441
references: Pharmacogenomics. 2012 Jun;13(8):955-62
references: 22676199
references: Am J Health Syst Pharm. 2011 Jan 15;68(2):143-50
references: 21200062
references: Nat Rev Clin Oncol. 2012 Feb 28;9(4):215-22
references: 22371130
references: Clin Pharmacol Ther. 2012 Apr;91(4):734-8
references: 22378157
references: Genet Med. 2010 Nov;12(11):680-3
references: 20975567
references: Lancet. 2012 May 5;379(9827):1705-11
references: 22464343
references: Genet Med. 2010 Nov;12(11):686-93
references: 20808229
references: Curr Cardiol Rep. 2013 Mar;15(3):345
references: 23338726
references: Am J Hum Genet. 2012 Nov 2;91(5):823-38
references: 23063622
references: Clin Pharmacol Ther. 2011 Mar;89(3):387-91
references: 21270794
references: Trials. 2010 Nov 17;11:108
references: 21083927
references: N Engl J Med. 2011 Nov 3;365(18):1663-72
references: 22047557
references: J Am Coll Cardiol. 2011 May 10;57(19):1920-59
references: 21450428
references: Circulation. 2011 Dec 6;124(23):e574-651
references: 22064601
references: Dialogues Clin Neurosci. 2010;12(1):69-76
references: 20373668
references: Clin Genet. 2012 Oct;82(4):388-94
references: 22698141
references: JAMA. 2012 Jul 25;308(4):387-402
references: 22820792
references: Clin Pharmacol Ther. 2011 Mar;89(3):348-50
references: 21326263
references: Clin Pharmacol Ther. 2013 Feb;93(2):153-8
references: 23232549
references: Pharmacogenomics. 2009 Oct;10(10):1687-95
references: 19842940
references: Circulation. 2011 May 10;123(18):e426-579
references: 21444888
references: Am J Gastroenterol. 2010 Mar;105(3):501-23; quiz 524
references: 20068560
references: Clin Pharmacol Ther. 2012 Oct;92(4):446-9
references: 22929923
references: JAMA. 2001 Feb 7;285(5):540-4
references: 11176855
references: Clin Pharmacol Ther. 2011 Mar;89(3):464-7
references: 21270786
references: Clin Pharmacol Ther. 2013 May;93(5):402-8
references: 23486447
references: Clin Pharmacol Ther. 2011 Oct;90(4):625-9
references: 21900891
references: Clin Pharmacol Ther. 2012 Oct;92(4):431-3
references: 22910442
references: Clin Pharmacol Ther. 2013 Jan;93(1):33-5
references: 23212102
references: Clin Pharmacol Ther. 2012 Jul;92(1):87-95
references: 22588608
references: Clin Pharmacol Ther. 2012 Feb;91(2):321-6
references: 22205192
references: Clin Pharmacol Ther. 2011 Aug;90(2):328-32
references: 21716271
references: Chest. 2012 Feb;141(2 Suppl):e152S-e184S
references: 22315259
references: JAMA. 2011 Nov 16;306(19):2099-109
references: 22089718