Pharmacogenomics · 2025
Opportunities and challenges for the implementation of pharmacogenomics in supportive care for gastrointestinal cancer patients in Zimbabwe.
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Mazhindu Tinashe Adrian, Ndlovu Ntokozo, Borok Margaret Z, Grimes Kevin, Masimirembwa Collen
Аннотация
INTRODUCTION: Supportive care in oncology aims to prevent and manage cancer-related side effects. This study reviews supportive medications for gastrointestinal cancer patients, analyzes usage patterns, biomarker frequencies, and feasibility of dose adjustments.
METHODOLOGY: A 10-year retrospective study was performed at Parirenyatwa group of Hospitals, Radiotherapy & Oncology Center evaluating the supportive care medicines prescribed for all gastrointestinal cancer patients.
RESULTS: A total of 607 patients were analyzed, 42% receiving cancer-specific treatment and 58% best supportive care. Patients who receive cancer-specific treatment, 200 participants (78%) received at least one supportive care medicine compared to 250 (71%) in the best supportive care group (OR 1.4; 95% CI 0.96-2; p = 0.08).Seventeen different supportive care medications were prescribed, seven (41%) of these have pharmacogenomic biomarkers testing recommendation. More patients in the cancer-treated group received medicines with actionable pharmacogenomic biomarkers than in the best supportive care group (56% versus 40%; OR 1.9; 95% CI 1.38-2.66; p = 0.0001). PGX guidelines were fully implemented for tramadol, codeine, omeprazole, and ondansetron; partially for ibuprofen and celecoxib; and unimplementable for amitriptyline.
CONCLUSION: There is an opportunity to improve supportive care in gastrointestinal cancer patients through pharmacogenomics though some specific medicines challenges to full implementations are due to limited registered medicines.
METHODOLOGY: A 10-year retrospective study was performed at Parirenyatwa group of Hospitals, Radiotherapy & Oncology Center evaluating the supportive care medicines prescribed for all gastrointestinal cancer patients.
RESULTS: A total of 607 patients were analyzed, 42% receiving cancer-specific treatment and 58% best supportive care. Patients who receive cancer-specific treatment, 200 participants (78%) received at least one supportive care medicine compared to 250 (71%) in the best supportive care group (OR 1.4; 95% CI 0.96-2; p = 0.08).Seventeen different supportive care medications were prescribed, seven (41%) of these have pharmacogenomic biomarkers testing recommendation. More patients in the cancer-treated group received medicines with actionable pharmacogenomic biomarkers than in the best supportive care group (56% versus 40%; OR 1.9; 95% CI 1.38-2.66; p = 0.0001). PGX guidelines were fully implemented for tramadol, codeine, omeprazole, and ondansetron; partially for ibuprofen and celecoxib; and unimplementable for amitriptyline.
CONCLUSION: There is an opportunity to improve supportive care in gastrointestinal cancer patients through pharmacogenomics though some specific medicines challenges to full implementations are due to limited registered medicines.