Should Drugs be Discontinued If DNA Predicts Risks?

On Pharmacogenetic Testing and Genomics – An Invitation

[By Karen D. Matthias RN MBA]

Dr. Marcinko and ME-P Readers

Wouldn’t it be wonderful to test someone’s DNA and know the right drug to prescribe at the right dose the first time without the worry of adverse side effects?  Pharmacogenetics—the manner in which a person’s genes affect their response to drugs, has the potential to do just that.  Genetic and genomic tests hold enormous promise for revolutionizing our medical understanding of a disease.

However, it is irresponsible to suggest that a simple genetic test, at this point in time, can appropriately dictate prescribing practices for certain drugs.

Pharmacogenetic Testing

The use of pharmacogenetic testing in the diagnosis and treatment of cancer has recently created a lot of questions for patients.  A high profile example is whether or not genetic tests can predict the risk of recurrence of breast cancer in women taking tamoxifen.

Our knowledge of how genetics and environment interact to dictate an individual’s response to a given drug is in its infancy. Therefore it is critically important that there is sufficient evidence to support the use of a given test before it is introduced into mainstream medical practice. In most cases, there is not a simple single genetic test that will give us the necessary information.

For example, Hayes has reviewed the evidence behind the pharmacogenetics of response to tamoxifen, and the reality is that there is currently insufficient evidence to conclude that performing a genetic test prior to prescribing this drug has any impact at all on patient outcomes.

Link: http://www.hayesinc.com/hayes/?s=Tamoxifen+

Assessment 

Furthermore, well-designed studies are needed to both confirm the relationship between genetic variants and response to tamoxifen. The critical component is to show that positive changes in patient care can be made in response to the results of genetic testing and to establish what the potential negative repercussions of NOT prescribing these drugs to patients may be.  It is possible that the benefits outweigh the risks, even for patients shown by genetic testing to be less likely to respond to treatment.

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ME-P Invitation from Hayes, Inc 

Dr. Diane J. Allingham-Hawkins would be available to give you, and your ME-P readers, a perspective on this ongoing genetics testing dialogue. Dr. Allingham-Hawkins is Director of the Genetics Test Evaluation Program at Hayes, Inc., an unbiased, healthcare research and consulting firm that is helping hospitals and insurers cope with the cost and ethical issues related to genetic testing.  She is an outspoken interviewee with deep knowledge of the subject matter and very pointed opinions regarding genetic testing.  A great interview for your consideration.

Contact Info:

Karen D. Matthias – Vice President

Hayes, Inc – 157 S. Broad Street

Lansdale, PA 19446

P: 215-855-0615 x7918

E-mail: kmatthias@hayesinc.com

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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