Table 2 Summary of the Coriell Personalized Medicine Collaborative drug-gene pharmacogenomics reports evaluated by the Pharmacogenomics Advisory Group
Drug and gene pair(s) | Approval status | Reason for rejection/deferral | Highly actionable genetic resultsa |
|---|---|---|---|
Warfarin and VKORC1 , CYP2C9 , CYP4F2 , or GGCX | All except GGCX approved | Insufficient clinical support for GGCX at time of submission evaluation | Low warfarin dose requirementb |
Clopidogrel and CYP2C19 | Approved | NA | Poor metabolizers |
Tamoxifen and CYP2D6 | Deferred | The data linking prognostic and predictive relevance of CYP2D6 variants to guide tamoxifen therapy for breast cancer was inconclusive. Vote has been deferred pending publication of anticipated clinical trials data | Vote deferred |
Codeine and CYP2D6 | Approved | NA | Ultra-rapid metabolizers |
Metoprolol and CYP2D6 | Rejected | Lack of clinical evidence, and given prescribing practices, the genetic results are unlikely to influence drug dose adjustment | NA |
Thiopurines and TPMT | Approved | NA | Intermediate and poor metabolizers |
PPIs and CYP2C19 | Approved | NA | None |
Diazepam and CYP2C19 | Rejected | Evidence for clinical consequences is weak | NA |
Statins and CYP3A4/CYP3A5 , SLCO1B1 , LDLR , or HMGCR | Simvastatin and SLCO1B1: approved, CYP3A4/CYP3A5: deferred. LDLR and HMGCR: rejected | LDLR and HMGCR: evidence for clinical utility is lacking | Simvastatin and SLCO1B1: genetic results associated with decreased hepatic drug uptake |
Celecoxib and CYP2C9 | Approved | NA | *3/*3 |
Fluorouracil and DPYD | Rejected | Combination of recent evidence for lower penetrance of reduced activity variants, and a lack of good alternative treatment reduces the clinical utility of the PGx information | NA |