Role of the genomics revolution in pharmaceutics

Neither of the two examples presented here is the perfect pharmacogenetics story, though they may be the best examples to date. Our goal is to highlight these two examples as a means of describing some of the problems that are common to many pharmacogenetic cases. The pharmacogenetic literature contains many examples of confusing, or even contradictory, studies that arise due to unknown environmental factors that result in poor outcomes; drugs whose metabolism/transport are affected by multiple genes in multiple pathways; and clinically important genes that have many rare allelic variants with similar phenotypes variation in the frequencies of allelic variants among ethnic groups that mask the role of any one variant. These issues are common to most gene/drug dynamics and do not preclude the importance of pharmacogenetic studies. They do call for more realistic assessments of the role of genetic testing for the practicing clinician as this field develops.