Experience with voluntary and required genomic data submissions to the FDA: summary report from track 1 of the third FDA-DIA-PWG-PhRMA-BIO pharmacogenomics workshop

Incorporating Pharmacogenomics into Practice

The goal for this issue of the Journal of Pharmacy Practice is to provide an overview of pharmacogenomics and highlight research done in select therapeutic areas such as oncology, psychiatry, cardiology, and HIV, although pharmacogenomics is taking center stage in other therapeutic areas as well. At the root of all pharmacogenomic investigations is pharmacy, which is why it is so important for pharmacists to gain an understanding of this field and clinical applications of this science, particularly as it relates to their practice and their patients. Pharmacists are experts in pharmacokinetics and pharmacodynamics, and they therefore represent ideal health care professionals for incorporating pharmacogenomics into therapeutic drug monitoring. We are currently in a critical period of time in which pharmacists need to become engaged in the decision-making process regarding how best to implement pharmacogenomics into clinical practice. As part of this chapter, we will outline the role of the Human Genome Project and the Food and Drug Administration, both of which are instrumental to the advancement of pharmacogenomics. Lastly, we will be summarizing some of the barriers we still face regarding clinical applicability of this science and the potential role of genetic counselors in the incorporation of this science into clinical practice.

Public-private collaborations and partnerships in stratified medicine: making sense of new interactions

The field of personalised or stratified medicine is evolving alongside the formation of a plethora of public/private partnerships and collaborations. These new institutional forms, or 'social technologies', are varied and emerge in response to several drivers, including the need to draw on a broader base of data inputs relating to genomics, patient behaviour and healthcare system differentiation. This paper discusses some of these drivers of partnerships and collaborations. Although the number of such partnerships is growing, their rationale and basis for collaboration remains unclear. Public-private collaborations are at the core of the set of new life sciences policies in the UK but there is little indication in the policy documents of clear boundaries for these partnerships. In part, this is due to the lack of empirical evidence at the system level for conceptualising what is still a relatively new approach. The collection of evidence in the form of broad evaluations, rather than tightly focused theoretical studies, is more likely to be related back to systems and be of more use for formulating policy rationales.

What do leaders of disease-specific advocacy organizations know about pharmacogenomics and biomarkers, anyway?

Disease Advocacy Organizations (DAOs) make meaningful contributions to the development of tests and therapeutics across the development pipeline, from cohort development to actual drug discovery. The process of developing biomarkers and validating them is fraught with a high failure rate and enormous expense. DAOs can harness new information technologies to increase effectiveness, including systems to dynamically consent individuals to participate in registries and trials. These new technologies can alleviate some of the expense in biomarker development. Information aggregation with consumer control of information at its core will eventually permit a national surveillance system for pre- and post-treatment analysis. A stronger and more scientific basis on which to build quality control and assurance of biomarker determination is needed. Validation must be supported in the future, in the same manner discovery was in the past, including through federal funding and philanthropic giving. DAOs can accelerate the process of biomarker development by building robust, well-characterized cohorts.

From pharmacogenomics to translational biomarkers

There is a need for new biomarkers to enable faster detection of adverse events due to drugs and disease processes. One would prefer biomarkers that are useful in multiple species (i.e., translational or bridging biomarkers) so that it would be possible to directly link responses between species and follow such injury in both preclinical and clinical settings. This chapter will explore some of the issues surrounding the use of pharmacogenomics to identify and qualify such biomarkers, and examples will be provided.

From the bench to the clinic and back again: translational biomarker discovery using in silico mining of pharmacogenomic data

To improve drug efficacy and safety and advance medical intervention in diseases, new biomarkers are urgently needed. Pharmacogenomics can provide a tool to discover and begin to qualify biomarkers useful for these indications and is readily applicable to multiple species. One can begin and end with genes or focus on tissue-derived expression analysis of those genes that encode secreted proteins to discover potential biomarkers that can be monitored in body fluids. The paper will discuss issues surrounding such investigations, show examples of translational biomarkers and end with a summary of the US FDA’s work in this field over the last 6 years.