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Tarantino et al. Cancer Drug Resist 2019;2:43-52 Cancer
DOI: 10.20517/cdr.2018.22 Drug Resistance

Review Open Access

Opportunities and challenges of implementing
Pharmacogenomics in cancer drug development

Paolo Tarantino , Dario Trapani , Stefania Morganti , Emanuela Ferraro , Giulia Viale , Paolo
1,2
1,2
1,2
1,2
1,2
D’Amico , Bruno Achutti Duso , Giuseppe Curigliano 1,2
1,2
1,2
1 Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan 20141, Italy.
2 Department of Oncology and Haematology (DIPO), University of Milan, Milan 20122, Italy.
Correspondence to: Prof. Giuseppe Curigliano, Division of Early Drug Development for Innovative Therapies, IEO, European
Institute of Oncology IRCCS, Via Ripamonti 435, Milan 20141, Italy. E-mail: giuseppe.curigliano@ieo.it
How to cite this article: Tarantino P, Trapani D, Morganti S, Ferraro E, Viale G, D’Amico P, Duso BA, Curigliano G. Opportunities
and challenges of implementing Pharmacogenomics in cancer drug development. Cancer Drug Resist 2019;2:43-52. http://
dx.doi.org/10.20517/cdr.2018.22

Received: 31 Oct 2018 First Decision: 12 Nov 2018 Revised: 1 Feb 2019 Accepted: 15 Feb 2019 Published: 19 Mar 2019

Science Editor: Enrico Mini Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Cancer drug development is a time and resources consuming process. Around 90% of drugs entering clinical trials
fail due to lack of efficacy and/or safety issues, more often after conspicuous research and economic efforts. Part
of the discarded drugs might be beneficial only in a subgroup of the study patients, and some adverse events might
be prevented by identifying those patients more vulnerable to toxicities. The implementation of pharmacogenomic
biomarkers allows the categorization of patients, to predict efficacy and toxicity and to optimize the drug development
process. Around seventy FDA approved drugs currently present one or more genetic biomarker to keep in consideration,
and with the progress of Precision Medicine tailoring therapies on individuals’ genomic landscape promises to become a
new standard of cancer care. In the current article we review the role of pharmacogenomics in cancer drug development,
underlying the advantages and challenges of their implementation.

Keywords: Pharmacogenomics, cancer drug development, precision medicine, clinical trials

INTRODUCTION
Since the development and approval of the first targeted agents, oncology care has moved from a one-
size-fits-all paradigm with pure histology-oriented approach toward a tailored treatment, selected upon

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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