Chicago, IL—Using genetic and pharmacogenomic information to treat patients with cancer in optimal fashion has advanced in the past several years, and the clinical utility of this approach should continue to improve as genetic research continues, said several panelists at a 2010 ASCO session on evaluating the evidence and marketing of genomic tests.
Unfortunately, clinicians too often pick the therapy they’re “most comfortable with, as opposed to the one the patient’s biology is driving us to wards,” said Howard L. McLeod, PharmD, of University of North Carolina at Chapel Hill. “We’re moving toward an era where it’s less of our choice and more of the tumor’s choice.”
Information on what therapy may impact a tumor has grown more common, Dr McLeod noted, emphasizing that many therapies, including irinotecan, cetuximab, and panitumumab, include pharmacogenomic information in the label. In addition, recent drug label updates have increased the amount of information provided, including, most importantly, actionable recommendations that impact clinical care.
Michael L. Maitland, MD, PhD, concentrated on these practical aspects of care. Noting that the current cost of sequencing an individual’s genome sequence is about $10,000, he indicated that by 2013, that cost should have dropped to $1000. Although not widely used at the moment, avoiding use of genetic information is becoming unacceptable, he argued.
A question from the audience highlighted the “in-between” state of pharmacogenomics in practice. Asked by a practicing oncologist if he should be testing his patients for CYP2D6 to guide care, Dr Maitland stated that “there’s not going to be a yes or no answer to that question.”
