Value of Supportive Care Pharmacogenomics in Oncology Practice
Value of Supportive Care Pharmacogenomics in Oncology Practice
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DOI：
10.1634/theoncologist.2017-0599
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发表时间：
2018-08-01
期刊：
影响因子：
5.8
通讯作者：
McLeod, Howard L.
中科院分区：
文献类型：
--
作者：
Patel, Jai N.;Wiebe, Lauren A.;McLeod, Howard L.
基因组医学为个体患者提供了个性化癌症治疗的机会。尽管新型靶向治疗延长了生存期，但大多数癌症患者仍会出现疼痛、抑郁、神经病变、恶心呕吐和感染等严重症状，这些症状严重影响了生活质量。这些症状的次优管理可能会对癌症治疗的反应和总体预后产生负面影响。遗传变异对药物反应的影响（也称为药物遗传学）有很好的记录，并直接影响个体患者对止吐药、阿片类药物、神经调节剂、抗抑郁药、抗真菌药等的反应。越来越多的药物基因组学数据现在可以指导临床医生从第一个处方中为癌症患者选择最安全和最有效的支持药物。这篇综述概述了一个理论上的病人的情况下，使用药物遗传学测试结果，个性化的支持性治疗在整个癌症护理continuous.Implications为PracticeIntegration的姑息治疗到癌症护理的连续性，导致了许多癌症类型的患者的生活质量和生存率的提高。然而，对疼痛、神经病变、抑郁、恶心和呕吐等症状的次优管理继续给癌症患者带来沉重负担。正如在这个理论案例中所证明的，药物基因组学可以对用于治疗这些疾病的药物的临床反应产生重大影响。与传统的试错法相比，药物基因组学在肿瘤学中的应用为临床医生提供了一种最安全、最有效的治疗方法，可以指导临床医生从第一次处方开始就为个体癌症患者选择最安全、最有效的支持性药物。这篇综述概述了一个理论上的病人的情况下，使用药物遗传学测试结果的影响，个性化的支持性治疗在整个癌症护理连续。
Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug responseotherwise known as pharmacogenomicsis well documented and directly influences an individual patient's response to antiemetics, opioids, neuromodulators, antidepressants, antifungals, and more. The growing body of pharmacogenomic data can now guide clinicians to select the safest and most effective supportive medications for an individual patient with cancer from the very first prescription. This review outlines a theoretical patient case and the implications of using pharmacogenetic test results to personalize supportive care throughout the cancer care continuum.Implications for PracticeIntegration of palliative medicine into the cancer care continuum has resulted in increased quality of life and survival for patients with many cancer types. However, suboptimal management of symptoms such as pain, neuropathy, depression, and nausea and vomiting continues to place a heavy burden on patients with cancer. As demonstrated in this theoretical case, pharmacogenomics can have a major effect on clinical response to medications used to treat these conditions. Recognizing the value of supportive care pharmacogenomics in oncology and application into routine practice offers an objective choice for the safest and most effective treatment compared with the traditional trial and error method.Pharmacogenomics can guide clinicians to select the safest and most effective supportive medications for an individual cancer patient from the very first prescription. This review outlines a theoretical patient case and the implications of using pharmacogenetic test results to personalize supportive care throughout the cancer care continuum.