Editorial Material
Oncology
D. Max Smith, William D. Figg
Summary: This commentary reviews a recent trial on the relationship between COMT genotype and opioid dose requirements, and discusses the potential role of COMT and other genes (such as CYP2D6) in opioid therapy. It also provides an overview of the current evidence for germline pharmacogenetics and available resources for opioid pharmacogenetics.
Article
Oncology
Natalie Reizine, Keith Danahey, Emily Schierer, Ping Liu, Merisa Middlestadt, Jenna Ludwig, Tien M. Truong, Xander M. R. van Wijk, Kiang-Teck J. Yeo, Monica Malec, Mark J. Ratain, Peter H. O'Donnell
Summary: This study analyzed the opioid exposures of 61,572 adult oncology patients and found that patients with abnormal CYP2D6 metabolizer status may experience inadequate pain control with common first-line opioids, resulting in increased pain-related hospitalizations. Preemptive genotyping could serve as a prospective evaluation tool to improve oncology pain management strategies.
Article
Pharmacology & Pharmacy
David R. Bright, Natasha Petry, Eric Roath, Tyler Gibb
Summary: The implementation of pharmacogenomics in opioid management faces a series of barriers, including the need for clinical and economic research, education and training, policy and public health considerations, as well as legal and ethical issues.
Article
Biochemistry & Molecular Biology
Danilo Cozzoli, Alessia Daponte, Salvatore De Fazio, Vincenza Ariano, Maria Rita Quaranta, Vincenzo Leone, Angelo Ostuni, Margherita Casanova, Claudia Rita Catacchio, Mario Ventura, Francesco Montinaro
Summary: Drug addiction is a chronic, relapsing disorder characterized by compulsive drug-seeking and drug-taking behavior despite negative consequences. Genetic studies are important in understanding the genetic basis of addiction, with a correlation observed between the risk of addiction to specific substances and heritability. Gene variations may play a role in transmission of core neurobiological factors of addiction. New sequencing technologies have enabled large-scale studies to identify genetic factors affecting drug addiction disorders and treatment response.
Review
Oncology
Jill Bates, Jeffrey Fudin, Jai N. Patel
Summary: Studies show a wide variation in pain management response, highlighting the need for improved methods of pain pharmacotherapy. Pharmacogenomics (PGx) involves studying how genetics influence response to medications, and PGx testing can aid in precise selection and dosing of pain medicines. The Clinical Pharmacogenetics Implementation Consortium (CPIC) provides guidelines on drug-gene interactions to guide more precise care in patients, and its application can enhance pain management strategies.
SUPPORTIVE CARE IN CANCER
(2022)
Article
Health Care Sciences & Services
Jennifer Philip, Aaron Wong, Leeanne Pasanen, Andrew A. Somogyi, Justin Rubio, Pal Klepstad, Anna Collins, Peter Gibbs, Brian Le
Summary: This study examined the feasibility of establishing an opioid pharmacogenomics registry for cancer patients. The results showed that establishing such a registry is feasible and acceptable by both patients and clinicians.
JOURNAL OF PALLIATIVE MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Katie Pizzolato, David Thacker, Nicole Marie Del Toro-Pagan, Nishita S. Amin, Abeer Hanna, Jacques Turgeon, Veronique Michaud
Summary: The opioid epidemic has highlighted the importance of limiting opioid dispensing and identifying at-risk patients. Pharmacogenomic testing allows clinicians to predict individual risk and response to opioids, leading to more personalized and effective pain management strategies.
PHARMACOGENOMICS & PERSONALIZED MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Emma Forton Magavern, Juan Carlos Kaski, Richard M. Turner, Heinz Drexel, Azara Janmohamed, Andrew Scourfield, Daniel Burrage, Christopher N. Floyd, Elizabeth Adeyeye, Juan Tamargo, Basil S. Lewis, Keld Per Kjeldsen, Alexander Niessner, Sven Wassmann, Patrick Sulzgruber, Pascal Borry, Stefan Agewall, Anne Grete Semb, Gianluigi Savarese, Munir Pirmohamed, Mark J. Caulfield
Summary: There is a growing body of evidence supporting the use of pharmacogenomics in cardiovascular pharmacology, but international cardiovascular societies lack a common position on the diverse availability, interpretation, and application of such data, as well as the challenges presented by variations in clinical practice across European countries. In addition to barriers to implementing pharmacogenomic testing and complexity in acting on results, there are disparities in the availability of resources and expertise internationally within Europe. Legal and ethical considerations for genomic testing and clinical therapeutic application also require serious thought.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Emma F. Magavern, Juan Carlos Kaski, Richard M. Turner, Heinz Drexel, Azara Janmohamed, Andrew Scourfield, Daniel Burrage, Christopher N. Floyd, Elizabeth Adeyeye, Juan Tamargo, Basil S. Lewis, Keld Per Kjeldsen, Alexander Niessner, Sven Wassmann, Patrick Sulzgruber, Pascal Borry, Stefan Agewall, Anne Grete Semb, Gianluigi Savarese, Munir Pirmohamed, Mark J. Caulfield
Summary: Pharmacogenomics shows promise in advancing cardiovascular therapy, but faces practical barriers in implementation within Europe due to differences in populations, resources, expertise, and ethical-legal frameworks. Clinical workforce upskilling is crucial, along with the development of digital infrastructure and clinical support tools to bridge healthcare delivery gaps and promote health equality.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Health Care Sciences & Services
Feng-Hua Loh, Brigitte Azzi, Alexander Weingarten, Zvi G. Loewy
Summary: This study assessed the impact of CYP2D6 pharmacogenomic testing on physicians' choice in prescribing chronic pain medications and patient pain control. Results showed that over 50% of patients had their medications altered as a result of the pharmacogenomic testing, with patients with intense, moderate, and mild pain categories being more likely to receive changes in pain medications.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Medicine, General & Internal
David R. Axon, Megan Grieser
Summary: This study investigates the variables associated with multimorbidity status among older US adults with self-reported pain and opioid use. The study finds that individuals aged 50-64, Hispanic, employed, and those who exercise frequently have lower odds of having multimorbidity.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Sebastiano Mercadante, Augusto Caraceni, Arturo Cuomo, Massimo Mammucari, Paolo Marchetti, Rocco Domenico Mediati, Silvia Natoli, Giuseppe Tonini
Summary: After one-month follow-up, cancer patients experienced a lower number of breakthrough pain episodes and peak intensity, potentially due to optimization of background analgesia. The principal characteristics of breakthrough pain did not change significantly, highlighting the importance of careful and continuous assessment for patients to alleviate the burden induced by breakthrough pain episodes.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Oncology
M. Fallon, K. Dierberger, M. Leng, P. S. Hall, S. Allende, R. Sabar, E. Verastegui, D. Gordon, L. Grant, R. Lee, K. McWillams, G. D. Murray, L. Norris, C. Reid, T. A. Sande, A. Caraceni, S. Kaasa, B. J. A. Laird
Summary: This study suggests that omitting step 2 of the WHO ladder in cancer pain management and using low-dose strong opioids as an alternative can be more efficient and cost-effective, with fewer side effects.
ANNALS OF ONCOLOGY
(2022)
Article
Biology
Sydney Trask, Jeffrey S. Mogil, Fred J. Helmstetter, Cheryl L. Stucky, Katelyn E. Sadler
Summary: The mechanisms underlying the transition from acute to chronic pain are still unclear, but it may involve the persistence or strengthening of pain memories acquired through associative learning. Recent studies have shown that contextual cues play a critical role in regulating pain memory. Animals and humans exhibit increased pain sensitivity in environments associated with painful experiences. This study suggests that pain perception and activation of endogenous opioid systems can be modified through psychological association with environmental cues.
Review
Surgery
Hala Muaddi, Erin Lillie, Stephanie Silva, Jori-Lee Cross, Karim Ladha, Stephen Choi, Aaron Mocon, Paul Karanicolas
Summary: This study systematically reviewed and meta-analyzed the effects of cryotherapy on closed incisions. The results showed that cryotherapy can significantly reduce postoperative pain and opioid consumption. However, it has no effect on hospital length of stay or surgical site infection rate.