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Drug efficacy and adverse drug reactions (ADRs) are defined, and the historical background to the field is introduced, along with a current overview of established clinically actionable gene\u2013drug interactions. HLA associations with ADRs are reviewed, including those associations already tested for in many H&amp;I laboratories worldwide, along with a broader overview of published HLA and ADRs, to determine which\u2014if any\u2014associations are likely to be of clinical significance and might be added to the testing repertoire. This review is intended to inform such decision\u2010making. In addition, pharmacogenomics as related to the transport and metabolism of immunosuppressive drugs used in clinical transplantation is considered, again with relevance to the testing repertoire of clinical H&amp;I laboratories. Finally, the expanding role of HLA genotyping in cancer immunotherapies is discussed, along with future developments in the broader pharmacogenomics field and how H&amp;I laboratories can contribute to this.<\/jats:p>","DOI":"10.1111\/iji.70052","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:49:32Z","timestamp":1777009772000},"page":"305-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Introduction to Pharmacogenomics: Role of the Histocompatibility and Immunogenetics Laboratory in Personalised Medicine\u2014Current Status and Future Prospects"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0812-108X","authenticated-orcid":false,"given":"William Martin","family":"Howell","sequence":"first","affiliation":[{"name":"Pathology Service Development NHS Blood and Transplant, Newcastle Centre, Holland Drive  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/PGPM.S21743"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.595219"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc\u20102020\u2010001620"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S23624"},{"key":"e_1_2_9_6_1","volume-title":"Histocompatibility Testing","author":"Amiel J. 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