Our Research

Pharmacogenomics is an area of science studying the role of inherited genetic differences as a factor for the variation in a person’s response to drugs. 

Currently, at London Health Sciences Centre (LHSC) we have successfully implemented pharmacogenomics-based Personalized Medicine service, both for inpatients and outpatients. A large proportion of the patients we see relate to pharmacogenomic testing for some chemotherapy medications used to treat cancer. For example, we carry out genotyping on the metabolism enzyme, dihydropyrimidine dehydrogenase deficiency (DPYD), prior to 5-fluorouracil or capecitabine chemotherapy to prevent severe adverse drug reactions that can sometimes result in hospitalization.  

We have seen over 3,000 patients for DPYD genotyping, and have shown that pretreatment dose adjustments in patients who are predicted to have partial or complete deficiency in this gene can reduce the risk of severe adverse side effects. Additionally, to the best of our knowledge, we are the first in the country to implement a Personalized Medicine Tamoxifen Clinic for breast cancer patients. Since 2010, we have provided point-of-care pharmacogenomic testing to over 1,000 patients resulting in the optimization of their care by genotyping in a drug metabolizing enzyme known as cytochrome P450 2D6 (CYP2D6) and measuring tamoxifen and endoxifen blood levels. 

Furthermore, we have implemented a robust pharmacogenomics program for gastroenterology patients, including patients with Crohn’s disease, Ulcerative Colitis and Gastroesophageal Reflux Disease (GERD), who are treated with medications such as azathioprine, biologics (infliximab and adalimumab), as well as for optimizing dose of Proton Pump Inhibitor (PPI) medications. Our ability to individualize drug dosing and selection not only enhance benefit from drug therapy, but also reduce health care utilization through a reduction in doctor visits and hospitalization associated with adverse drug reaction.

Additionally, future projects are planned in the areas of pediatrics, transplant medications and the role of non-coding RNA in the regulation of drug transport and metabolism genes.

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