Pharmacogenomic tests in Oncology - finding the right dose

ABSTRACT

A pharmacogenetics/genomics (PGx) anticancer drug testing program is being developed by Kurtz and his group at the Brazilian National Cancer Institute (INCA). Drug -gene pairs were selected for PGx testing based on the presence of clinically validated PGx associations and the availability of international guidelines with PGx-informed dosing recommendations. Fluoropyrimidines-DPYD, irinotecan-UGT1A1 and thiopurines-TPMT/NUDT15 were initially included. The current estimation of anticancer therapy doses usually does not reflect the complexities of metabolism. Therefore, efforts should be made in order to refine the ways we prescribe these drugs, being conventional cytotoxic or newer ones. This program is extremely welcome and may lead to more multi-institutional partnerships and should bring a broader discussion on the use of PGx and pharmacokinetics in routine oncology practice.

RESUMO

Um programa farmacogenética / genômica (PGx) para drogas anticancer está sendo desenvolvido por Kurtz e seu grupo no Instituto Nacional do Câncer (INCA). Pares de droga-gene foram selecionados para o teste de PGx com base na presença de associações de PGx clinicamente validadas e na disponibilidade de diretrizes internacionais com recomendações de dosagem informadas por PGx. Fluoropirimidinas-DPYD, irinotecanoUGT1A1 e tiopurinas-TPMT / NUDT15 foram inicialmente incluídos. A estimativa atual de dosagem da terapia anticâncer geralmente não reflete as complexidades do metabolismo. Portanto, esforços devem ser feitos para refinar as formas de prescrever esses medicamentos, sejam os citotóxicos convencionais como os mais novos. Este programa é extremamente bem-vindo e pode levar a mais parcerias multi-institucionais e deve trazer uma discussão mais ampla sobre o uso de PGx e farmacocinética na prática oncológica.

Keywords:

DPYD - fluoropyrimidines - irinotecan - NUDT15 - pharmacogenomics - thiopurines - TPMT - UGT1A1

Descritores:

DPYD - fluoropirimidinas - irinotecano - NUDT15 - farmacogenômica - tiopurinas - TPMT - UGT1A1

Publication History

Received: 09 December 2020

Accepted: 19 December 2020

Article published online:
14 May 2021

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