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Applications of pharmacogenomics in regulatory science: a product life cycle review. THE PHARMACOGENOMICS JOURNAL 2017; 18:359-366. [PMID: 29205206 DOI: 10.1038/tpj.2017.47] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/05/2017] [Accepted: 09/18/2017] [Indexed: 01/11/2023]
Abstract
With rapid developments of pharmacogenomics (PGx) and regulatory science, it is important to understand the current PGx integration in product life cycle, impact on clinical practice thus far and opportunities ahead. We conducted a cross-sectional review on PGx-related regulatory documents and implementation guidelines in the United States and Europe. Our review found that although PGx-related guidance in both markets span across the entire product life cycle, the scope of implementation guidelines varies across two continents. Approximately one-third of Food and Drug Administration (FDA)-approved drugs with PGx information in drug labels and half of the European labels posted on PharmGKB website contain recommendations on genetic testing. The drugs affected 19 and 15 World Health Organization Anatomical Therapeutic Chemical drug classes (fourth level) in the United States and Europe, respectively, with protein kinase inhibitors (13 drugs in the United States and 16 drugs in Europe) being most prevalent. Topics of emerging interest were novel technologies, adaptive design in clinical trial and sample collection.
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Tremaine L, Brian W, DelMonte T, Francke S, Groenen P, Johnson K, Li L, Pearson K, Marshall JC. The role of ADME pharmacogenomics in early clinical trials: perspective of the Industry Pharmacogenomics Working Group (I-PWG). Pharmacogenomics 2015; 16:2055-67. [PMID: 26616152 DOI: 10.2217/pgs.15.141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Genetic polymorphisms in metabolizing enzymes and drug transporters have been shown to significantly impact the exposure of drugs having a high dependence on a single mechanism for their absorption, distribution or clearance, such that genotyping can lead to actionable steps in disease treatment. Recently, global regulatory agencies have provided guidance for assessment of pharmacogenomics during early stages of drug development, both in the form of formal guidance and perspectives published in scientific journals. The Industry Pharmacogenomics Working Group (I-PWG), conducted a survey among member companies to assess the practices relating to absorption, distribution, metabolism, excretion pharmacogenomics) during early stages of clinical development, to assess the impact of the recent Regulatory Guidance issued by the US FDA and EMA on Industry practices.
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Affiliation(s)
- Larry Tremaine
- Pfizer Inc., Worldwide Research & Development, Department of Pharmacokinetics, Dynamics & Metabolism, Eastern Point Road, Groton, CT 06340, USA
| | - William Brian
- Sanofi, Disposition, Safety & Animal Research, 55 Corporate Drive, Bridgewater, NJ 08807, USA
| | - Terrye DelMonte
- Bristol Myers Squibb, Clinical Sample Strategy & Operations, Exploratory & Clinical Translational Research, 311 Pennington Rocky Hill Rd, Pennington, NJ 08534, USA
| | - Stephan Francke
- Janssen Research & Development, 1400 McKean Rd, PO Box 776, Spring House, PA 19477, USA
| | - Peter Groenen
- Actelion Pharmaceuticals Ltd, Translational Science, Gewerbestrasse 16, 4102 Allschwil, Switzerland
| | - Keith Johnson
- Veritas Genetics Inc., 99 Conifer Hill Drive, Danvers, MA 01923, USA.,Novartis Institutes for Bio Medical Research, Inc., 250 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Lei Li
- Veritas Genetics Inc., 99 Conifer Hill Drive, Danvers, MA 01923, USA.,Novartis Institutes for Bio Medical Research, Inc., 250 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Kimberly Pearson
- Sanofi, Disposition, Safety & Animal Research, 55 Corporate Drive, Bridgewater, NJ 08807, USA
| | - Jean-Claude Marshall
- Pfizer Inc., Worldwide Research & Development, Department of Pharmacokinetics, Dynamics & Metabolism, Eastern Point Road, Groton, CT 06340, USA
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Lesko LJ, Schmidt S. Clinical implementation of genetic testing in medicine: a US regulatory science perspective. Br J Clin Pharmacol 2014; 77:606-11. [PMID: 24286486 DOI: 10.1111/bcp.12299] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 11/19/2013] [Indexed: 12/26/2022] Open
Abstract
Heterogeneity of treatment effects in unselected patient populations has stimulated various strategic approaches to reduce variability and uncertainty and improve individualization of drug selection and dosing. The rapid growth of DNA sequencing and related technologies has ramped up progress in interpreting germline and somatic mutations and has begun to reshape medicine, especially in oncology. Over the past decade, regulatory agencies realized that they needed to be proactive and not reactive if personalized medicine was to become a reality. The US Food and Drug Administration, in particular, took steps to nurture the field through peer-reviewed publications, co-sponsoring public workshops and issuing guidance for industry. The following two major approaches to personalized medicine were taken: (i) encouragement of de novo co-development of drug-genetic test combinations by industry; and (ii) retrospective assessment of legacy genetic data for the purpose of updating drug labels. The former strategy has been more successful in getting new targeted therapies to the marketplace with successful adoption, while the latter, as evidenced by the low adoption rate of pharmacogenetic testing, has been less successful. This reflection piece makes clear that several important things need to happen to make personalized medicine diffuse in more geographical areas and among more therapeutic specialties. The debate over clinical utility of genetic tests needs to be resolved with consensus on evidentiary standards. Physicians, as gatekeepers of prescription medicines, need to increase their knowledge of genetics and the application of the information to patient care. An infrastructure needs to be developed to make access to genetic tests and decision-support tools available to primary practitioners and specialists outside major medical centres and metropolitan areas.
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Affiliation(s)
- Lawrence J Lesko
- Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, FL, USA
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