Wrenda Teeple, Jeffrey A Shaman, Tootie Tatum, Ben L Kong, J Shawn Jones, Sara L Rogers
{"title":"STRIPE partners in precision medicine: regulatory perspective.","authors":"Wrenda Teeple, Jeffrey A Shaman, Tootie Tatum, Ben L Kong, J Shawn Jones, Sara L Rogers","doi":"10.1038/s41397-025-00386-x","DOIUrl":"https://doi.org/10.1038/s41397-025-00386-x","url":null,"abstract":"","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 5","pages":"27"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William P Duggan, Mohammedreza Azimi, Lyndsey Flanagan, Graeme P Sullivan, Ian S Reynolds, Joanna Fay, Heiko Dussmann, Tríona Ní Chonghaile, Katherine M Sheehan, Karin Jirström, Jochen H M Prehn, John P Burke
{"title":"Serine-arginine protein kinase 1 (SRPK1) is under-expressed in mucinous colorectal cancer, and may mediate resistance to oxaliplatin.","authors":"William P Duggan, Mohammedreza Azimi, Lyndsey Flanagan, Graeme P Sullivan, Ian S Reynolds, Joanna Fay, Heiko Dussmann, Tríona Ní Chonghaile, Katherine M Sheehan, Karin Jirström, Jochen H M Prehn, John P Burke","doi":"10.1038/s41397-025-00384-z","DOIUrl":"https://doi.org/10.1038/s41397-025-00384-z","url":null,"abstract":"<p><p>5-15% of all colorectal cancers (CRCs) are mucinous. Mucinous CRCs are associated with an inhibited response to standard adjuvant and neoadjuvant therapies. Serine-Arginine Protein Kinase 1 (SRPK1) is an enzyme, which modulates the activity of multiple splicing factors. SRPK1 under-expression is associated with resistance to platinum-based chemotherapeutic agents in multiple tumor types. The objectives of this study were to evaluate SRPK1 expression in mucinous CRC and to explore the potential relationship between differential SRPK1 expression and oxaliplatin resistance in mucinous CRC. Rectal cancer and CRC Tissue Microarrays (TMA) were stained with SRPK1 to compare expression between mucinous and non-mucinous tumors. SRPK1 expression was analyzed in mucinous and non-mucinous CRC cell lines. Cells were treated with oxaliplatin to explore differences in treatment response. Mucinous cells were transfected with an SRPK1 CRISPR/Cas9 lentiviral activation plasmid to investigate the relationship between SRPK1 expression and oxaliplatin resistance. The TMA cohorts included 117 patients with mucinous and 441 patients with non-mucinous CRC. SRPK1 was found to be under-expressed in both the mucinous rectal cancer (P < 0.001) and CRC cohorts (P = 0.003). On univariate analysis, SRPK1 under-expression was found to be associated with worse 5-year OS (P = 0.001). Treatment of mucinous CRC cells with oxaliplatin did not result in a significant increase in cell death (P = 0.149). However overexpression of SRPK1 following transfection with a CRISPR/CAS9 activation plasmid resulted in a significant increase in sensitivity of these cells to oxaliplatin treatment (P = 0.029). SRPK1 is under-expressed in mucinous CRC, and under-expression is associated with worse OS. This may be due to the positive effects of SRPK1 on oxaliplatin sensitivity.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 5","pages":"26"},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryley Uber, Vanessa A Hayduk, Alison Flango, Theron Ward, Leeann Webster, Eric A Wright
{"title":"An innovative model for pharmacogenomics critical results identification and intervention.","authors":"Ryley Uber, Vanessa A Hayduk, Alison Flango, Theron Ward, Leeann Webster, Eric A Wright","doi":"10.1038/s41397-025-00385-y","DOIUrl":"https://doi.org/10.1038/s41397-025-00385-y","url":null,"abstract":"<p><p>Pharmacogenomics (PGx) test results are returned variably across healthcare settings, which can lead to challenges particularly when results require immediate intervention to avoid adverse consequences. While several return of result models exist in literature, a standard-of-care has not been established. We propose a model to safely return PGx results in the context of scaled and sustained PGx testing: an institutional protocol to integrate new PGx results into patient care.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 5","pages":"25"},"PeriodicalIF":2.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M M Roth, C R Meier, C A Huber, H E Meyer Zu Schwabedissen, S Allemann, C Schneider
{"title":"Antidepressant drug switching in the Swiss population with a focus on Escitalopram and drugs with pharmacogenetic dosing guidelines: a drug utilization study using claims data.","authors":"M M Roth, C R Meier, C A Huber, H E Meyer Zu Schwabedissen, S Allemann, C Schneider","doi":"10.1038/s41397-025-00382-1","DOIUrl":"10.1038/s41397-025-00382-1","url":null,"abstract":"<p><p>Depression affects around 10% of the Swiss population. While SSRIs are commonly prescribed, only 30-40% of patients achieve remission. Pharmacogenetic (PGx) factors may explain part of this high rate of SSRI treatment failure. This study examined antidepressant (AD) switching among Swiss patients using escitalopram, focusing on whether they switched to ADs with PGx dosing guidelines (PGx AD) or ADs without PGx dosing guidelines (non-PGx ADs). Data from Swiss health insurance records identified 41 275 patients who used escitalopram between July 2020 and June 2022. While 6.4% (n = 2 638) switched to another antidepressant, only 35.4% of these opted for a PGx AD. Men, younger adults showed higher switching rates, whereas patients on antipsychotic medications switched less. Individuals younger than 20 years old and women were more likely to switch to PGx AD whereas the elderly were less likely to switch to PGx AD.</p>","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 5","pages":"24"},"PeriodicalIF":2.9,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mike Zack, Ioan Slobodchikov, Danil Stupichev, Alex Moore, David Sokolov, Igor Trifonov, Allan Gobbs
{"title":"Benchmarking large language models for replication of guideline-based PGx recommendations","authors":"Mike Zack, Ioan Slobodchikov, Danil Stupichev, Alex Moore, David Sokolov, Igor Trifonov, Allan Gobbs","doi":"10.1038/s41397-025-00383-0","DOIUrl":"10.1038/s41397-025-00383-0","url":null,"abstract":"We evaluated the ability of large language models (LLMs) to generate clinically accurate pharmacogenomic (PGx) recommendations aligned with CPIC guidelines. Using a benchmark of 599 curated gene–drug–phenotype scenarios, we compared five leading models, including GPT-4o and fine-tuned LLaMA variants, through both standard lexical metrics and a novel semantic evaluation framework (LLM Score) validated by expert review. General-purpose models frequently produced incomplete or unsafe outputs, while our domain-adapted model achieved superior performance, with an LLM Score of 0.92 and significantly faster inference speed. Results highlight the importance of fine-tuning and structured prompting over model scale alone. This work establishes a robust framework for evaluating PGx-specific LLMs and demonstrates the feasibility of safer, AI-driven personalized medicine.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tanuma Mistry, Sanghamitra Sengupta, R. Suresh Kumar, Nisha Thakur, Partha Nath, Neyaz Alam, Vilas D. Nasare
{"title":"Impact of low BMI and ABCC2 genotype on the clinical response of sequential anthracycline-taxane chemotherapy receiving breast cancer patients: a hospital-based study","authors":"Tanuma Mistry, Sanghamitra Sengupta, R. Suresh Kumar, Nisha Thakur, Partha Nath, Neyaz Alam, Vilas D. Nasare","doi":"10.1038/s41397-025-00380-3","DOIUrl":"10.1038/s41397-025-00380-3","url":null,"abstract":"This study investigates combine effect of low BMI and possible pharmacogenetic influence of ABC gene polymorphisms in treatment responses of BC patients. BMI was analysed prior to commencement of chemotherapy. Clinical response was evaluated by radiological imaging and categorised as per RECISTv.1 criteria. SNPs (C1236T, C3435T, C58626A) in ABCB1 and ABCC2 gene were selected. 148 patients were analysed using PCR-RFLP. ABCC2 (58626AA) was significantly associated with treatment non-responsiveness in all genetic models namely dominant (OR 2.954; [1.442–6.051]; p = 0.003), recessive (OR 5.723; [2.48–13.20]; p < 0.0001), codominant (χ2 21.219; p < 0.0001). The proportion of ORR and NRs were significantly different between low (<18.5) and high (≥18.5) BMI classes (OR 16.097; [7.12–36.35]; p < 0.0001). Furthermore, when treatment response was combined with BMI groups, significant associations were observed for C58626A SNP across all genetic models among low BMI group: dominant (OR 3.324; [1.012–10.406]; p = 0.041), recessive (OR 7.250; [1.533–34.278]; p = 0.012) and codominant (χ2 8.657; p = 0.013). Both PFS (35.31 months; p = 0.005) and OS (39.75 months; p = 0.032) were lowered among AA genotype (ABCC2) while the hazard risk of this genotype was further increased in low BMI patients (HR 1.963). 3435CT genotypes in ABCB1 gene showed 87% reduction in risk of death (HR 0.13; p = 0.025). Low BMI independently and jointly with 58626AA genotype of ABCC2 gene was responsible for poor chemotherapy response and survival outcome among AC-T regimen receiving BC patients. Together, this study underscores the importance of genetic counselling and nutritional assessment for favourable treatment outcomes.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacogenomic-guided opioid therapy for pain: a systematic review and meta-analysis of randomised controlled trials","authors":"S. Jethwa, M. Ball, K. Langlands","doi":"10.1038/s41397-025-00379-w","DOIUrl":"10.1038/s41397-025-00379-w","url":null,"abstract":"Optimising opioid therapy is challenging due to variable patient responses linked to genetic variation. Pharmacogenomic-guided prescribing holds promise for personalisation, but its clinical effectiveness requires evaluation. We performed a systematic review and meta-analysis of RCTs comparing pharmacogenomic-guided versus standard opioid prescribing in adults. Adhering to PRISMA, we assessed risk of bias (RoB 2) and evidence certainty (GRADE). Six RCTs met inclusion criteria from 2496 screened articles. Meta-analysis showed pharmacogenomic-guided prescribing was associated with significantly reduced opioid consumption (SMD −0.38, 95% CI −0.67 to −0.08, p = 0.01). However, no significant difference in pain intensity was observed between groups (SMD −0.31, 95% CI −0.89 to 0.27, p = 0.30). Evidence regarding adverse events was limited to one trial, which reported a statistically significant reduction in incidence in the pharmacogenomic group (median [IQR]: 1 [0–2] vs. 3 [1–5]; p < 0.01). Further research is needed to determine if pharmacogenomics can improve opioid therapy outcomes.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nina L. Wittwer, Christoph R. Meier, Carola A. Huber, Romy Tilen, Canan Yilmaz, Henriette E. Meyer zu Schwabedissen, Samuel Allemann, Cornelia Schneider
{"title":"Utilisation of drugs with pharmacogenetic recommendations in children in Switzerland","authors":"Nina L. Wittwer, Christoph R. Meier, Carola A. Huber, Romy Tilen, Canan Yilmaz, Henriette E. Meyer zu Schwabedissen, Samuel Allemann, Cornelia Schneider","doi":"10.1038/s41397-025-00378-x","DOIUrl":"10.1038/s41397-025-00378-x","url":null,"abstract":"Pharmacogenetics (PGx) is increasingly implemented in the adult population, but its potential in children remains uncertain. The aim of this study was to investigate PGx drug utilization in children in Switzerland, using Helsana claims data between 2017 and 2021. We identified 82 drugs with paediatric guideline annotations associated with variants in 24 genes from the Pharmacogenomics Knowledgebase. Of 159 172 children continuously insured, 66.1% claimed at least one PGx drug during the study period. The three PGx drugs with the highest user numbers were systemically administered ibuprofen (59.1%), ondansetron (8.3%), and locally administered fluorouracil (7.5%). Over 96% of all potential drug-gene interactions were caused by seven genes (CYP2C9, CYP2D6, DPYD, CYP2C19, MT-RNR1, CACNA1S, and RYR1). The high number of children claiming PGx drugs in Switzerland implies that a significant number of children could benefit from PGx testing.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mayuri S. Patel, Emily J. Cicali, Frank A. Orlando
{"title":"Analyzing pharmacogenetics cost effectiveness and savings across common health conditions in the United States","authors":"Mayuri S. Patel, Emily J. Cicali, Frank A. Orlando","doi":"10.1038/s41397-025-00376-z","DOIUrl":"10.1038/s41397-025-00376-z","url":null,"abstract":"This review describes healthcare cost effectiveness/savings for pharmacogenetics (PGx) and relevant clinical outcomes in selected common health conditions. PGx allows targeted drug treatment based on genotype and phenotype. Studies highlight how PGx testing reduces the morbidity and mortality of adverse drug reactions (ADRs) by predicting unexpected drug metabolism due to genetic variation in cytochrome P450 enzymes (CYPs) and drug-drug interactions caused by altered CYP enzyme phenotype. Despite many available PGx testing platforms and PGx-guided treatments, clinical implementation remains challenging and slow due to limited (1) insurance coverage and reimbursement of testing and pharmacist interpretation, (2) outcome data such as evidence showing the benefits of preemptive PGx testing for efficacy or ADR prevention, and (3) promotion of PGx testing among healthcare professionals. Of these, cost is the most significant barrier to patients and the healthcare system. This review describes how PGx testing can be cost effective or cost saving for payors and the healthcare system, especially for depression, cardiovascular disease, and ADRs.","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}