Pharmacists have long recognized that using unique patient characteristics to guide pharmacotherapy decision-making can improve drug response and mitigate drug-associated risks. Age, weight, and dietary habits were among the first patient-specific characteristics used to individualize pharmacotherapy. As technologies advanced, analytic tools that measure surrogate markers of liver and renal function, together with drug concentrations in biological fluids, were adopted to optimize therapeutic regimens. Cutting-edge genomic technologies are now being integrated into patient care for the selection of targeted therapies and identification of those at increased risk of poor pharmacotherapy outcomes. Precision Pharmacotherapy is combining genetic, environmental, lifestyle, and other unique patient or disease characteristics to guide drug selection and dosage. This session will introduce the concept and give many examples of how precision pharmacotherapy is used in specialties such as pediatrics, psychology, cardiology and oncology to guide prescribing.
Dr. Relling has been a pioneer in both the science and clinical application of pharmacogenomics. Her research has resulted in seminal laboratory discoveries that unraveled the mechanisms of drug-induced adverse effects, and the integration of biologic, genomic, and pharmacologic discoveries into comprehensive clinical protocols, leading to improved cure rates for children with acute lymphoblastic leukemia. She has led the implementation of clinical protocols for pharmacogenomics at St. Jude Medical as well as their integration into clinical care. In recognition for her work she was elected to the Institute of Medicine (now National Academies of Medicine) in 2009 and also received the Pediatric Oncology Award from ASCO. More recently, Mary has been recognized by the American Society for Clinical Pharmacology and Therapeutics, receiving the Rawls Palmer Progress in Medicine Award. Mary, along with Dr. Teri Klein of Stanford, co-led the formation of the Clinical Pharmacogenomics Implementation Consortium (CPIC) that has published pharmacogenetic guidelines for thirty-five drugs, removing a barrier to pharmacogenetic testing in the clinic. These guidelines are now being implemented around the globe. Mary received her Bachelor of Science degree from the University of Arizona and her PharmD from the University of Utah College of Pharmacy.
William E. Evans is recognized for his research on the pharmacogenomics of leukemia treatment in children. His lab elucidated the pharmacodynamics of methotrexate treatment of acute lymphoblastic leukemia and discovered the genetic basis for inherited differences in the enzyme thiopurine methyltransferase and defined its role in determining the risk of hematopoietic toxicity in patients treated with mercaptopurine and azathioprine. More recently, his lab has used genomewide strategies to elucidate the importance of both inherited and somatic genome variation in determining the efficacy and toxicity of leukemia chemotherapy. He has been funded by 3 successive NIH MERIT awards and has produced over 400 research publications. He served as CEO of St. Jude Children’s Research Hospital in Memphis TN (USA) from 2004-2014, and was elected into the US National Academy of Medicine in 2002.