Aug 2026· Journal of chemotherapy· pp.
1-21
· 0 citations· 144 references
Medicine
TL;DR
A critical evaluation of clinically validated PGx biomarkers for chemotherapeutics and targeted therapy with a focus on translational relevance and strength of evidence shows high-impact germline markers such as DPYD, TPMT, NUDT15 and UGT1A1 are highlighted as key determinants of genotype-guided dosing for improving safety without compromising efficacy.
Abstract
Interpatient variability in chemotherapy response and toxicity remains a major challenge in oncology. Pharmacogenomics (PGx) is an approach to address this challenge by combining somatic alterations that affect tumour sensitivity with germline variants that affect drug metabolism, transport and toxicity. This review provides a critical evaluation of clinically validated PGx biomarkers for chemotherapeutics and targeted therapy with a focus on translational relevance and strength of evidence. High-impact germline markers such as DPYD, TPMT, NUDT15 and UGT1A1 are highlighted as key determinants of genotype-guided dosing for improving safety without compromising efficacy. Somatic biomarkers such as EGFR, RAS, BRAF, and HER2 remain central to treatment selection, while resistance underscores the need for ongoing molecular assessment. A tiered implementation framework, barriers to progress, and future directions involving polygenic models, multi-omics, and artificial intelligence (AI) are discussed to advance safe, effective, and personalized chemotherapy.
Although substantial evidence supports the association between UGT1A1 genotype and drug safety, implementation of genotype-guided treatment remains inconsistent, and further harmonization of international recommendations, high-quality prospective studies, and wider access to pharmacogenetic testing are needed to support routine implementation.
S. Vitale, Melissa Drago, F. Martorana et al.· Pharmaceutics· 0 citations
Personalized medicine, also called precision medicine, is an approach to disease prevention and treatment that accounts for individual variability in genes, environment, and lifestyle. In oncology it has driven a decisive shift away from empirical, one-size-fits-all chemotherapy toward biomarker-directed care in which the molecular profile of a tumour, rather than its anatomical site alone, guides treatment selection. This review summarizes the current status and future prospects of personalized oncology. It outlines the biological rationale rooted in the genomic basis of cancer and the concept of oncogene addiction, and describes the enabling technologies - next-generation sequencing, comprehensive genomic profiling, large reference atlases, and liquid biopsy that have made molecular characterization feasible in routine care. The clinical achievements of targeted therapy are reviewed across haematological and solid tumours, together with the advent of immune checkpoint blockade and the first histology-independent, biomarkerdefined drug approvals. Innovations in clinical trial design, including basket and umbrella trials and frameworks for ranking the clinical actionability of molecular alterations, are considered alongside cellular therapies such as chimeric antigen receptor T cells. The review also addresses persistent challenges drug resistance, tumour heterogeneity, the still-modest proportion of patients who benefit, and issues of cost and equitable access before considering future directions in multi-omics, minimal residual disease monitoring, combination strategies, and the integration of artificial intelligence. Realizing the full promise of personalized oncology will require continued biological discovery, pragmatic trial designs, and deliberate attention to accessibility.
Mohd Faizan Siddiqui· International Research Journ...· 0 citations
The integration of pharmacogenomics into routine healthcare has the potential to optimize individualized drug therapy, minimize preventable ADRs, and accelerate the transition toward precision medicine, ultimately improving clinical outcomes and healthcare quality.
Rayapudi Vasavi Sai Saraswati, U. M. Vattikuti, Arthika Chauhan Laudia et al.· International Journal of Cur...· 0 citations
A comprehensive overview of emerging and targeted therapeutic strategies in colorectal cancer, with emphasis on their molecular basis and clinical relevance, highlights a shift toward precision oncology for improved management of colorectal cancer.
Debgopal Ganguly, Ananta Choudhury, Himangshu Deka et al.· Clinical and Translational O...· 0 citations