Review ArticlePharmacogenomicsRoss, Jeffrey S MD*†; Schenkein, David P MD†; Kashala, Oscar MD, PHD, DSC†; Linette, Gerald P MD, PHD*‡; Stec, James*; Symmans, W Fraser MD§; Pusztai, Lajos MD, PHD§; Hortobagyi, Gabriel N MD§Author Information From the *Division of Molecular Medicine, Millennium Pharmaceuticals, Inc, Cambridge, Massachusetts; †Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York; ‡Department of Medicine, Washington University, St Louis, Missouri; and §Departments of Breast Medical Oncology and Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Reprints: Jeffrey S. Ross, MD, Department of Pathology and Laboratory Medicine, MC 80, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208 (e-mail: [email protected]). Advances in Anatomic Pathology: July 2004 - Volume 11 - Issue 4 - p 211-220 doi: 10.1097/01.pap.0000131825.77317.ee Buy Metrics Abstract The discovery of the human genome and subsequent expansion of proteomics research combined with emerging technologies such as functional imaging, biosensors and sophisticated computational biology are producing unprecedented changes in today’s healthcare. The expanding knowledge of the molecular basis of cancer has shown that significant differences in gene expression patterns can guide therapy not only for neoplastic conditions, but also for a variety of diseases including inflammatory disorders, cardiovascular disease and neurodegenerative processes. As a result, the fields of pharmacogenetics and pharmacogenomics have emerged as potential new testing platforms for the individualized management of patients. An individual’s response to a drug is the complex interaction of both genetic and non-genetic factors. Genetic variants in the drug target itself, disease pathway genes, or drug metabolizing enzymes may all be used as predictors of drug efficacy or toxicity. In oncology, the SNP technology has focused on detecting the predisposition for cancer, predicting of toxic responses to drugs and selecting the best individual and combinations of anti-cancer drugs. Pharmacogenomics involves the application of whole genome technologies (e.g., gene and protein expression data) for the prediction of the sensitivity or resistance of an individual’s disease to a single or group of drugs. Genomic microarrays and transcriptional profiling have the ability to generate hundreds of thousands of data points requiring sophisticated and complex information systems necessary for accurate and useful data analysis. This technique has generated a wealth of new information in the fields of leukemia/lymphoma, and solid tumor classification and prediction of metastasis, drug and biomarker target discovery and pharmacogenomic drug efficacy testing. © 2004 Lippincott Williams & Wilkins, Inc.