Pharmacogenetics (PG) refers to the hereditary basis of drug response and has held the promise of pharmacotherapy that is individualised both in the selection and dosing of medications, the potential of which is enticing for clinicians like oncologists faced with prescribing drugs that have unpredictable side effects and narrow therapeutic windows. The aim of PG in clinical care is to direct drug and dosing decisions that can render higher efficacy and improved safety to their use. The basis of PG is that interindividual variability of anticancer treatment is partially related to genetics, either germline or somatic. The pace of PG discoveries and associations with drug therapy has accelerated in recent years as a consequence of technological improvements in genomic tools that can de-encrypt genetic material in massively parallel fashion at falling costs and advances in bioinformatics that evaluate massive dimensions of genomic and clinical data. More recently, apart from structural polymorphisms that associate with drug response, other common genetic lesions that can potentially influence phenotype include copy number variations, gene translocation and fusion and epigenetic modulation. In somatic tissues, gene expression profiles have added to the list of predictors studied for drug treatment.
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