Personalised Therapeutics @ LUMC

The response to medicines varies greatly between patients. Pharmacogenetics investigates to what extent differences in the genetic profile provide a statement and can be used to prevent side effects and ineffectiveness of drugs. Pharmacogenetics is currently being used to a greater extent for individual drugs being tested for one of a few genetic variants. A major disadvantage of this approach is that a relatively large number of patients must be tested to prevent one side effect. Testing on a panel of genetic variants is probably a much more effective method. Research shows that if such a test is carried out with a panel consisting of 56 variants in 13 genes (a so-called Pharmacogenetic passport), 95% of the Dutch population finds 1 variant on the basis of which treatment should be adjusted and that 10% has 4 of more of these variants themselves.

If the pharmacogenetic profile of all Dutch people were known in 2016, almost 200,000 first prescriptions would have been adjusted. A pharmacogenetic profile for a panel of genes can therefore have major consequences for the prescription of medicines. A limitation of the current knowledge of pharmacogenetics is that only 50% of the applied variability in the response to drugs can be explained. This is partly caused within pharmacogenetics, because only a very small part (~ 0.01%) of the genetic variation is used. In addition, non-genetic factors that cause the reaction to a drug are taken into account. The proposed research project offers the most advanced knowledge of pharmacogenetics in routine care in the LUMC for 2,000 patients. In addition, an app will be developed that will collect information from these 2,000 patients on their response to drug treatment and create a unique dataset for discovering new genetic variants and non-genetic factors for drug response.