Oharmacogenetic testing -Pro
There tests for Major and moderate gene-drug interactions. AN example is RightMed test. It is a Pharmacogenetic test. The records do not indicate reactions to 5 FU or other chemotherapy medications. Guidelines do not recommend routine testing with pharmacogenetics in the context of chemotherapy, unless an unexpected toxicity to 5 FY is seen. . he current NCCN Guidelines highlight some genetic alterations that may impact drug metabolism and drug–drug interactions, specifically in terms of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and tricyclic antidepressants.7 Of note, metabolism of both codeine and tramadol seems to be highly influenced by CYP2D6 genetic variation; treatment with opioids that are not metabolized by CYP2D6, such as morphine, hydromorphone, and oxymorphone, is recommended as an alternative for individuals with known deficiencies in this pathway.
Alfaro Alfaro ÁE, Murillo Castillo B, Cordero García E, Tascón J, Morales AI. Colon Cancer Pharmacogenetics: A Narrative Review. Pharmacy (Basel). 2022 Aug 5;10(4):95.
Relling MV, Schwab M, Whirl-Carrillo M et al. Clinical Pharmacogenetics Implementation Consortium Guideline for Thiopurine Dosing Based on TPMT and NUDT15 Genotypes: 2018 Update. Clin Pharmacol Ther. 2019;105(5):1095-1105.
Amstutz U, Henricks LM, Offer SM et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 Update. Clin Pharmacol Ther. 2018;103(2):210-216.
Swarm RA, Youngwerth JM, Agne JL, et al. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Adult Cancer Pain. Version 1.2022. Accessed April 12, 2022