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Please use this identifier to cite or link to this item: https://hdl.handle.net/11055/1153
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dc.contributor.authorSomogyi AAen_US
dc.date2022-08-24-
dc.date.accessioned2023-03-07T03:26:48Z-
dc.date.available2023-03-07T03:26:48Z-
dc.date.issued2022-10-
dc.identifier.citation23(10):1353-1369.en_US
dc.identifier.issn1534-6277en_US
dc.identifier.urihttps://hdl.handle.net/11055/1153-
dc.description.abstractPharmacogenomics is increasingly important to guide objective, safe, and effective individualised prescribing. Personalised prescribing has revolutionised treatments in the past decade, allowing clinicians to maximise drug efficacy and minimise adverse effects based on a person's genetic profile. Opioids, the gold standard for cancer pain relief, are among the commonest medications prescribed in palliative care practice. This narrative review examines the literature surrounding opioid pharmacogenomics and its applicability to the palliative care cancer population. There is currently limited intersection between the fields of palliative care and pharmacogenomics, but growing evidence presents a need to build linkages between the two disciplines. Pharmacogenomic evidence guiding opioid prescribing is currently available for codeine and tramadol, which relates to CYP2D6 gene variants. However, these medications are prescribed less commonly for pain in palliative care. Research is accelerating with other opioids, where oxycodone (CYP2D6) and methadone (CYP2B6, ABCB1) already have moderate evidence of an association in terms of drug metabolism and downstream analgesic response and side effects. OPRM1 and COMT are receiving increasing attention and have implications for all opioids, with changes in opioid dosage requirements observed but they have not yet been studied widely enough to be considered clinically actionable. Current evidence indicates that incorporation of pharmacogenomic testing into opioid prescribing practice should focus on the CYP2D6 gene and its actionable variants. Although opioid pharmacogenomic tests are not widely used in clinical practice, the progressively reducing costs and rapid turnover means greater accessibility and affordability to patients, and thus, clinicians will be increasingly asked to provide guidance in this area. The upsurge in pharmacogenomic research will likely discover more actionable gene variants to expand international guidelines to impact opioid prescribing. This rapidly expanding area requires consideration and monitoring by clinicians in order for key findings with clinical implications to be accessible, meaningfully interpretable and communicated.en_US
dc.subjectAnalgesicsen_US
dc.subjectCanceren_US
dc.subjectOpioiden_US
dc.subjectPalliative careen_US
dc.subjectPharmacogenomic variantsen_US
dc.subjectPrecision medicineen_US
dc.titleThe Role of Pharmacogenomics in Opioid Prescribingen_US
dc.typeJournal Articleen_US
dc.type.contentTexten_US
dc.identifier.journaltitleCurrent treatment options in oncologyen_US
dc.identifier.doi10.1007/s11864-022-01010-xen_US
dc.description.affiliatesDiscipline of Pharmacology, Faculty of Health and Medical Sciences, University of Adelaideen_US
dc.description.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/36001223/en_US
dc.type.studyortrialCase Control Studiesen_US
dc.ispartof.anzcaresearchfoundationYesen_US
dc.type.specialtyAnaesthesiaen_US
dc.type.specialtyPain Medicineen_US
item.cerifentitytypePublications-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
Appears in Collections:Scholarly and Clinical
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