Personalized genomics for improving drug safety: From discovery to implementation.

Medications ideally improve patient health, occasionally with mild or moderate side effects. But sometimes patients have significant damaging responses to drugs, events called adverse drug reactions (ADRs). In Canada, there are 87,000 – 200,000 debilitating or life-threatening ADRs, which cause 3,600 – 10,000 deaths each year. The problem is worse in children, where ADRs are three times more life threatening than in adults.

The treatment of childhood cancer is especially impacted by ADRs: a staggering 73 percent of childhood cancer patients develop chronic health conditions from their treatment and 42 percent experience a disability or threat to life.

By better understanding debilitating and life-threatening ADRs in childhood cancer treatment, and generating ADR-predictive tools and prevention strategies, this project aims to benefit the lives of thousands of children and families. Over the past 10 years, collaborations with clinicians, policy makers, and industry partners have generated a sample pool of well-characterized patients for a group of priority ADRs.

This research program will analyze patient DNA to identify genetic factors that help predict ADRs. These will be validated through functional and mechanistic studies. Rapid and cost-effective lab tests will be developed to identify patients at high risk of severe ADRs. Moving knowledge into practice, clinical guidelines will be developed and drug label changes will be pursued, where appropriate, based on the findings.

Ultimately, this work will enable new strategies to protect patients from ADRs. For example, it should be possible to re-purpose certain drugs or use alternative treatment regimes in cases where predictive tools detect a risk of certain ADRs.