Pharmacogenomic Testing in Current Clinical Practice: Implementation in the Clinical Laboratory.
How will reading this book change the way I think about things? This is an important question that perhaps should be asked of any book we engage. In this case the editors, Wu and Yeo, have seen to it that this book will indeed change how we view and think about the emerging discipline of pharmacogenetics, with emphasis on where we are today in laboratory medicine.
The delivery of healthcare has been transitioning rapidly from an intuitive approach to what has been labeled a more precisioned practice of medicine (1). Recognizably, clinical laboratories continue to play a central and emerging role in enabling this transition (2). Many challenging elements are involved in the practice of laboratory medicine: economics, technology development, regulations, novel applications, emphasis on demonstrating clinical efficacy, practitioner/patient education, and importantly, willingness of practitioners to try new approaches (3). Every so often, these elements must be reviewed and put into perspective relative to the body of literature that supports positioning of the facts. Two recent examples with emphasis on the role of clinical laboratory medicine in the genre of personalized medicine have been describe in published reports (4, 5). The recent text edited by Wu and Yeo follows suit and demonstrably extends the knowledge base to date, with noticeable advantages.
A report published in Clinical Chemistry in 1997 issued a call to awareness that a new tide was approaching that involved the use of information heavily focused on how genetics affects pharmacotherapy in personalizing therapeutic interventions (2). This line of thought began to shape the conversation among the clinical laboratory community toward recognition of its role in transitioning the science of pharmacogenetics, developed so elegantly and advanced by many, into clinical practice settings. Not surprisingly, the number of published reports that invoke pharmacogenetics (or pharmacogenomics) has blossomed in the last decade (Fig. 1). Interestingly, since 1997 only 8 published works in Clinical Chemistry use those key words in titles or abstracts. Perhaps more information is needed on this topic, with emphasis on applications in our own clinical chemistry literature.
[FIGURE 1 OMITTED]
In regard to the recent book edited by Wu and Yeo, several observations are immediately evident. The text is very well referenced with ample figures and tables that are easy to read and provide concise perspectives. Although some are original, others are from previous publications. Nevertheless, the individual authors should be commended for providing very illustrative and informative summaries. One feature that struck me as very refreshing compared to other recent texts on these topics was the inclusion of case reports, typically at the conclusion of many of the chapters. These case reports provide good examples and demonstrate the clinical applications of the preceding information. As one might anticipate in a book in which each chapter was written by different authors (and in some cases a bit many), the prose style varies. Nevertheless, an audience engaged in understanding how pharmacogenetics is shaping our future in laboratory medicine will find that all the relevant topics are covered and the list of evolving challenges noted above is addressed. An important feature is the extensive referencing throughout the text, which includes very current publications. The inclusion of current references in such a volume is important because in our rapidly changing environment a repository of this information can facilitate our understanding of the limitations of present thinking. Individuals involved with providing clinical laboratory advice, managing laboratories, or preparing regulatory documents, and entrepreneurs looking for new opportunities in personalized medicine should take a close look. In short, this compact, well-illustrated, and thoughtfully thorough text will provide the thought-changing activation energy that should be required of any such reading initiative.
Authors' Disclosures or Potential Conflicts of Interest: Upon manuscript submission, all authors completed the Disclosures of Potential Conflict of Interest form. Potential conflicts of interest:
Employment or Leadership: R. Valdes, University of Louisville.
Consultant or Advisory Role: None declared.
Stock Ownership: R. Valdes, PGXLLaboratories, LLC.
Honoraria: None declared.
Research Funding: R. Valdes, NIH.
Expert Testimony: None declared.
Acknowledgments: I thank Dr. Lu Yang for generously providing the data for Fig. 1.
(1.) Christiansen CM, Grossman JH, Hwang J. The innovators prescription. New York: McGraw Hill; 2009.
(2.) Linder MW, Prough RA, Valdes R Jr. Pharmacogenetics: a laboratory tool for optimizing therapeutic efficiency. Clin Chem 1997;43: 254-66.
(3.) Valdes R Jr, Payne DA, Linder MW (eds). Guidelines and recommendations for laboratory analysis and application of pharmacogenetics to clin ical practice. Washington (DC): National Academy of Clinical Biochemistry; 2010.
(4.) Wong S, Linder MW, Valdes R Jr (eds). Pharmacogenomics and proteomics: enabling the practice of personalized medicine. Washington (DC): AACC Press; 2006.
(5.) Reynolds KK, Valdes R Jr (eds). Clinics in laboratory medicine, pharmacogenetics. Philadelphia: Elsevier; 2008.
--Roland Valdes, Jr.
* Address correspondence to this author at: University of Louisville, MDR Bldg. 511 S. Floyd Street, Rm. 222, Louisville, KY40202. Fax 502-852-7674; e-mail: firstname.lastname@example.org.
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|Author:||Valdes Jr., Roland|
|Article Type:||Book review|
|Date:||May 1, 2012|
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