Why it’s not that easy to turn CYP testing into personalised medicine07-02-2018
On Thursday February 22nd they will be in the Mærsk Tower for the Cytochrome P450 Symposium.
Here are some clues about what to expect:
Senior Director Birgitte Buur Rasmussen from Ferring Pharmaceuticals will bring us on the same page, by taking us through a quick and basic introduction to the cytochrome p450 enzyme system.
“The idea is to introduce the topic on a very basic level, allowing people with different backgrounds to be able to follow what is being discussed in the next two talks”, she says.
Research Associate Professor Gesche Jürgens, University Hospital of Sjælland will focus on the clinical utility of CYP testing. She has published a Health Technology Assessment of antipsychotic polypharmacy in the treatment of schizophrenia.
Her stance is one of relative scepticism towards CYP testing as an example of personalised medicine.
“We are interested in individualisation of drug treatment. In theory, poor metabolizers are at increased risk of side effects, while ultra-rapid metabolizers risk treatment failure. Thus, it appears to be obvious that CYP testing could help to find individualized dose regimens. But clinical practice reveals that it is not that simple”, says Gesche Jürgens.
“Many factors have to add up before we can make relevant choices. A few examples:
Even though a gene test shows a patient is a poor metabolizer, the standard medication may be adequate as other factors than the genes are important.
Are physicians interpreting the test in the same way and do they understand its clinical implications?
So what does it take to utilise the CYP test result into a clinical decision with the desired outcome?”, asks Gesche Jürgens.
Professor Kim Brøsen from Odense University Hospital will finish by giving an overview of the research area, both past and present. One of the challenges in the area of personalised medicine is to translate the laboratory research into clinical practice, as it is expensive and difficult.
“In order for this to translate into clinical practice, you need to do clinical studies, and the main problem is to get enough funding for this type of research.”
Technological developments have meant that whole genome sequencing on a larger scale is now within reach.
“The challenge is to handle all these data. When I started this research area, we did studies on a little number of healthy patients. There were not more data than one single person could handle, but now you have to deal with millions of gene variants in many different subjects. It requires complicated bioinformatics to deal with. And it’s complicated to draw meaningful conclusions and then to do the correct follow-up studies in clinical practice,” says Kim Brøsen.