Personalized Medicine: Pharmacokinetics

Dear colleagues,

Personalized medicine is a challenging target in a real-life clinical setting. Even if it is widely reported in scientific and medical literature, its use in patient care is not yet a common practice, due to many factors, such as healthcare professionals’ teaching and information, large clinical validation, and the complexity and interplay between sources of variability. Pharmacogenetics is widely used in oncology to select the best drugs for specific pharmacodynamic targets. One of the principal sources of variability is linked to the pharmacokinetics of drugs. Drug metabolic enzymes and transporters are the key factors in this variability. Genetic and environmental factors, such as drug–drug interactions and clearance organs failure (kidney and liver), affect the pharmacokinetics of drugs, affecting their safety and efficacy. In some cases, drugs’ metabolites could be responsible for toxicity, like for reactive metabolites. Many drugs are generally produced as stereoisomers, but only one of the isomers is active, and sometimes the other one is toxic, such as methadone where (R)-methadone is responsible of the opioid effect, while (S)-methadone is responsible for the cardiac toxicity of this molecule. Genetic polymorphisms and drug–drug interactions affecting the pharmacodynamic targets are also important in the variability of drug response, and need to be more studied and validated in large clinical studies.

The present issue could address:

• Recent updates in genetic polymorphisms of metabolic enzymes, transporters and their implication in different medical fields (oncology, psychiatry, cardiovascular, etc.)
• Genetic polymorphisms affecting pharmacodynamics of drugs in oncology
• Pharmacogenetics and pharmacogenomics of tyrosine kinase inhibitors
• Pharmacogenetics and pharmacogenomics of anticoagulant and antiplatelet drugs
• Better characterization of drugs metabolism and transport during the development and use of physiologically based pharmacokinetics (PBPK) for optimal use in clinical settings

Prof. Dr. Youssef Daali
Guest Editor

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