Zhang Yingqi, Somtakoune Seumsack Dennis, Cheung Christina, Listiawan Mario, Feng Xiaodong
California Northstate University College of Phamracy, Elk Grove, CA, USA.
California Northstate University College of Medicine, Elk Grove, CA, USA.
AAPS J. 2016 Jul;18(4):819-29. doi: 10.1208/s12248-016-9926-x. Epub 2016 May 13.
Personalizing cancer treatment has been proved to be difficult for healthcare providers due to the nature of chemotherapies which includes narrow therapeutic indices, severe and potential life-threatening toxicities, and variable response rates and efficacies. Studies in pharmacogenomics (PGx) may help guide clinicians to personalize treatment for cancer patients. Implementing PGx in cancer treatment may offer choices to anticipate differences in drug response, resistance, efficacy, and toxicity within chemotherapeutic agents and targeted immune biologic agents. This can be used to achieve optimization of treatment regimens based on patients' variability. Many of the cancer treatment agents are biologics targeting specific antigens expressed on cancer cells, or blocking stimulators and signal transduction pathways of tumor growth, or enhance anticancer immune responses. It is now crucial for clinicians to understand the important association of clinically important biomarker polymorphisms with the clinical benefits of cancer therapies. By identifying specific PGx biomarker polymorphisms present in cancer cells, physicians can select and tailor a patient's treatment based on his or her genetic profile. PGx-guided cancer treatment may have the ability to improve the survival of patients while avoiding the unnecessary cost due to unresponsive treatment and toxicities of that patients experience.
由于化疗的特性，包括治疗指数狭窄、严重且可能危及生命的毒性以及可变的反应率和疗效，医疗服务提供者已证明个性化癌症治疗颇具难度。药物基因组学（PGx）研究可能有助于指导临床医生为癌症患者进行个性化治疗。在癌症治疗中实施PGx可为预测化疗药物和靶向免疫生物制剂在药物反应、耐药性、疗效和毒性方面的差异提供选择。这可用于根据患者的个体差异实现治疗方案的优化。许多癌症治疗药物是针对癌细胞上表达的特定抗原、阻断肿瘤生长的刺激因子和信号转导通路或增强抗癌免疫反应的生物制剂。临床医生了解临床重要生物标志物多态性与癌症治疗临床获益之间的重要关联如今至关重要。通过识别癌细胞中存在的特定PGx生物标志物多态性，医生可以根据患者的基因概况选择并定制治疗方案。PGx指导的癌症治疗或许有能力提高患者的生存率，同时避免因治疗无反应和患者所经历的毒性而产生的不必要费用。
