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Treat. Options in Oncol."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Opinion statement<\/jats:title>\n                  <jats:p>\n                    Pharmacogenomics is increasingly important to guide objective, safe, and effective individualised prescribing. Personalised prescribing has revolutionised treatments in the past decade, allowing clinicians to maximise drug efficacy and minimise adverse effects based on a person\u2019s genetic profile. Opioids, the gold standard for cancer pain relief, are among the commonest medications prescribed in palliative care practice. This narrative review examines the literature surrounding opioid pharmacogenomics and its applicability to the palliative care cancer population. There is currently limited intersection between the fields of palliative care and pharmacogenomics, but growing evidence presents a need to build linkages between the two disciplines. Pharmacogenomic evidence guiding opioid prescribing is currently available for codeine and tramadol, which relates to\n                    <jats:italic>CYP2D6<\/jats:italic>\n                    gene variants. However, these medications are prescribed less commonly for pain in palliative care. Research is accelerating with other opioids, where oxycodone (\n                    <jats:italic>CYP2D6<\/jats:italic>\n                    ) and methadone (\n                    <jats:italic>CYP2B6<\/jats:italic>\n                    ,\n                    <jats:italic>ABCB1<\/jats:italic>\n                    ) already have moderate evidence of an association in terms of drug metabolism and downstream analgesic response and side effects.\n                    <jats:italic>OPRM1<\/jats:italic>\n                    and\n                    <jats:italic>COMT<\/jats:italic>\n                    are receiving increasing attention and have implications for all opioids, with changes in opioid dosage requirements observed but they have not yet been studied widely enough to be considered clinically actionable. Current evidence indicates that incorporation of pharmacogenomic testing into opioid prescribing practice should focus on the CYP2D6 gene and its actionable variants. Although opioid pharmacogenomic tests are not widely used in clinical practice, the progressively reducing costs and rapid turnover means greater accessibility and affordability to patients, and thus, clinicians will be increasingly asked to provide guidance in this area. The upsurge in pharmacogenomic research will likely discover more actionable gene variants to expand international guidelines to impact opioid prescribing. This rapidly expanding area requires consideration and monitoring by clinicians in order for key findings with clinical implications to be accessible, meaningfully interpretable and communicated.\n                  <\/jats:p>","DOI":"10.1007\/s11864-022-01010-x","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T02:03:33Z","timestamp":1661306613000},"page":"1353-1369","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["The Role of Pharmacogenomics in Opioid Prescribing"],"prefix":"10.1007","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6507-1219","authenticated-orcid":false,"given":"Aaron K.","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Somogyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Rubio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"1010_CR1","doi-asserted-by":"crossref","unstructured":"Roden DM, McLeod HL, Relling MV, Williams MS, Mensah GA, Peterson JF, et al. 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Wong, Justin Rubio, and Jennifer Philip have no conflicts to disclose. Andrew A. Somogyi is a member of the Clinical Pharmacogenetics Implementation Consortium (CPIC) and co-authored the following paper: \u201cCrews KR, Monte AA, Huddart R, Caudle KE, Kharasch ED, Gaedigk A, et al. Clinical pharmacogenetics implementation consortium guideline for CYP2D6, OPRM1, and COMT genotypes and select opioid therapy. Clinical Pharmacology & Therapeutics. 2021;110(4):888-96.\u201d","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}]}}