Two clinical Associate Professors from the Norfolk and Norwich University Hospital (NNUH) are leading a groundbreaking study into the use of pharmacogenomics in palliative care, the first time this topic has been explored in the UK.
What is pharmacogenomics?
Pharmacogenomics is the study of how our genes affect the way we respond to medications. It can be used as a potential tool in personalised medicine, helping to guide safe prescription of medication base on genetic makeup.
Dr Caroline Barry and Dr Martyn Patel began to explore the area after discovering they had a shared interest in the subject. They decided to carry out a review to question whether pharmacogenomics can help clinicians choose the best medicines to manage symptoms for patients during end-of-life care.
This review found that many of the medications used in palliative care may be susceptible to ‘drug-gene interactions’ – an association between a drug and a genetic variant which may impact the patient’s response to medications and treatment.
The review was published in the latest issue of BMJ Supportive and Palliative Care and selected as Editor’s Choice.
Important work
Dr Barry, Consultant in Palliative Care at NNUH, said: “Through our scoping review we found that it is both feasible and acceptable to test people’s genes in palliative care, however more clinical trials are needed to see if pharmacogenomics can improve symptom management for people receiving palliative and supportive care.”
The importance of this work has been recognised by the NHS Pharmacogenomics Network of Excellence, who have funded NNUH to undertake further work in this area in collaboration with researchers from the Manchester Centre for Genomic Medicine.
Dr Patel, Consultant in Older People’s Medicine and Head of the UEA Medicines Optimisation Group, added: “We are due to start an observational trial called PISCES in this area to carry out genetic testing, which will help gather evidence on the prevalence of genes that interact with common symptom control medication, recruiting patients under the supervision of palliative care teams at NNUH.
We are very grateful for all the assistance from the NNUH Research and Development team in reaching this step.”
Dr Bernard Brett, Medical Director at NNUH said: “Congratulations to Dr Patel and Dr Barry for succeeding in gaining funding for this important project.
Genomics will enable us to develop personalised treatment plans for our patients, with the optimal medications and doses and has the potential to transform patient care for those with a wide variety of conditions.
Palliative care always needs a personalised approach to meet our patients needs and pharmacogenomics is an important area of research to enable us to optimise the drugs we use to reduce symptoms.”
The full research paper can be read here.
Find out more about the PISCES trial here.
