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Pharma Tech Outlook | Friday, December 23, 2022
New developments in pharmacogenomics provide key insights for informed trial design, specifically in oncology studies where both germline and acquired mutations play a role.
FREMONT, CA:The increased relevance of pharmacogenomics in explaining individual differences in drug responses is evident in the market’s growth. The CRISPR Cas-9 gene editing, computer-assisted structural simulation and DNA reactivity technology offer key insights for informed trial design, particularly in oncology studies. The precision medicine market is expected to grow significantly with the growing demand bringing to the fore the need to conduct pharmacogenomics studies adding new dimensions to clinical trials.
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Gene Variations and Pharmacogenomics
Variations in genes coding for specific enzymes, drug targets, or even transporters are associated with drug toxicity and may be used for finding likely responses to drug products. Knowing such variations that are present from birth or germline variations are inherited and are used as biomarkers to understand the pharmacokinetics of drugs.
Inter-individual Differences in Drug Response
There are inter-individual differences in the response to drugs that are multifactorial and difficult to predict but are partly associated with inherited genetic variations. Variations in genes associated with absorption, distribution, metabolism, and excretion are associated with a drug’s pharmacokinetics (PKs) and pharmacodynamics (PDs), affecting several aspects of drug outcome. In addition, gene variations are associated with drug dosing, toxicity, the extent of the effect, and even drug resistance and hypersensitivity.
Evolving Genetic Testing Landscape
The genetic testing and genomic services ecosystem is rapidly evolving with the main drivers being advances in technology, improved utilisation of genetic information, and information delivery. Tiered single-gene methods and multigene panels paved the way for genome-wide sequencing, and genome or exome sequencing, increasing the potential for faster genetic testing services. These advances have improved the clinical use of genetic information or pharmacogenomics. This wide-ranging field of study leverages the information present in DNA variants to identify people with hypersensitivity to a few drugs.
Digital Health Technologies
The use of digital devices has been shown to significantly advance the conduct of pharmacogenomic clinical trials. Using wearable devices is common in many clinical trials, where user activity is tracked via a device to capture digital biomarkers and associated outcomes such as walking, sleeping, or amassing electrocardiograms. In psychiatry pharmacogenomic studies, episodes of anxiety are monitored using such wearable devices.
Other exciting devices that are used in pharmacogenomic trials include a device to measure blood pressure and anticoagulation levels for pharmacogenetic trials focused on cardiac therapy. There are specifically designed apps that can be used on smartwatches to detect how many times an individual carries out hand-to-mouth gestures. An effective app that can be used to understand the association of gene variants with smoking cessation.
Pharmacogenomics is poised for greater acceptance and relevance with pragmatic clinical trial design required to tap into advancements in DNA technology and digital health solutions to harness the big data from genomics. This will help transform care and offer highly targeted medical therapy. Supported by efficient clinical trials, pharmacogenomics will help in shaping the future of medicine.
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