Precision medication management, including DNA testing, is extremely important for the proper treatment of cancer — finding the right drug and dose is vital. Over half of all medications, including the majority of cancer medications, are metabolized by three enzymes in the liver: CYP2D6, CYP2C9, and CYP2C19. Other metabolic pathways include CYP1A2, DPYD, NAT2, UGT1A, and TPMT. [4]
If you have too much of an enzyme, you process the medication too quickly. Too little of the enzyme and the medication builds up in your bloodstream potentially causing adverse reactions or side effects.
Without a clear picture of your genetic makeup, your physician may need to go through months of trial-and-error prescribing to find the right drug and dose for you.
PGx FOR CANCER PATIENTS
Discover the Right Cancer Treatment, Faster
Genelex pharmacogenetic testing complements current efforts to optimize treatment of cancer and leads towards effective and personalized care — all while being more cost effective and reducing trial-and-error efforts.
With advances in genetics, you are now able to optimize your response to cancer drugs and many other medications through DNA testing. In partnership with YouScript, a leader in drug-drug and drug-gene interaction software, you'll get a report highlighting patient-specific genetic markers and potential interactions, allowing for drug and dosage decisions to be catered to your needs.
Read below for more specific information on how different oncology pharmaceuticals are impacted by variations in your genes.
Population Frequency of Cytochrome P450 Metabolizer Types [5]
| Poor Metabolizer | Intermediate Metabolizer | Normal Metabolizer | Rapid or Ultra Rapid Metabolizer | |
|---|---|---|---|---|
| CYP2D6* | 4-7% | 9-35% | 50-90% | 2-3% |
| CYP2C9 | 3% | 30% | 68% | N/A |
| CYP2C19* | 2-20% | 24-36% | 14-44% | 30% |
*CYP2C19 variability depends on ethnicity.
*CYP2D6 Variability depends on ethnicity and classification of Intermediate activity
Some cancer medications and involved metabolic pathways include:[6]
| TRADE NAME | DRUG | GENE |
|---|---|---|
| Adrucil® | fluorouracil | DYPD |
| Beleodaq® | belinstat | UGT1A1 |
| Camptosar® | irinotecan | UGT1A1 |
| Iressa® | gefitinib | CYP2D6 |
| Lanvis® | thioguanine | TPMT |
| Nolvadex® | tamoxifen | CYP2D6 |
| Platinol® | cisplatin | TPMT |
| Purixan® | mercaptopurine | TPMT |
| Quinamed® | amonafide | NAT2 |
| Rubraca® | rucaparib | CYP1A2, CYP2D6 |
| Tasigna® | niloinib | UGT1A1 |
| Votrient® | pazopanib | UGT1A1 |
| Xeloda® | capecitabine | DYPD |