Precision Medicine: Tailoring Treatment to Your DNA

Jun. 10, 2016

Imagine if an individual’s DNA could be matched to the most effective medication to treat his or her case specifically. Using pharmacogenomics, researchers and providers are getting closer to achieving this goal.

A form of precision medicine, which involves matching individual characteristics to treatment, pharmacogenomics focuses on how pharmacology and genetics work together.

Utilizing this method, researchers look at the genes of a person to understand how they might react to a treatment. For example, the presence of a certain gene might lead to a heightened chance of developing certain side effects from a drug.

“I’m interested in how we can guide therapies based on genetics of the patient,” said Pamala Jacobson, PharmD, a pharmacogenomics researcher in the University of Minnesota College of Pharmacy. Jacobson is also a Masonic Cancer Center member.

Because drug regimens were developed to work for the average person, drugs are not 100 percent effective; some people have a great response to a drug while others have no response or a bad response to the same drug. Experts need to discern who might react negatively to a certain treatment regimen so they can prescribe an effective treatment program.

Jacobson studies how to effectively use immunosuppressant’s for kidney transplants that require certain genetic predictors, such as how fast a person can metabolize a drug.

“If the drug is metabolized quickly, it will leave the blood system quickly,” Jacobson said. “Those metabolizing quickly will be at risk for therapy failure.”

Jacobson also researches certain genetic predictors in relation to chemotherapy and bone marrow transplants. Certain predictors show if someone needs high versus low exposure to chemotherapy.

Jacobson developed a model aiming to help clinicians identify the best treatment options. She wants to use this model to decrease the risk of treatment related mortality.

“Right now everyone gets the same dose,” Jacobson said. “We want to use models and individual characteristics to predict the optimal dose for each person.”

The large amount of genetic data each person carries makes pharmacogenomics challenging. It’s difficult for experts to identify what each gene represents in relation to pharmacology.

“Our entire genome is billions of base pairs and we all differ,” Jacobson said. “How do you even begin to start interpreting all of those base pairs?”

According to Jacobson, some genetic variants are meaningless while others can result in serious harm, so it’s important to identify which ones might be relevant or not.

“In the long run, we need to find therapies that are highly effective and 100 percent safe,” Jacobson said. “To be 100 percent effective and safe may not be realistic but that’s what precision medicine is about.”

A Precision Medicine Conference was held in June 2016 that brought together precision medicine experts from across the Midwest to discuss this growing field.

(Originally published on Health Talk)


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