Welcome to the new world of pharmacogenomics

This article in the NYTimes about genetic testing that differentiates the risk of recurrence for women with breast cancer and, therefore, affects treatment decisions in some cases is a harbinger of things to come. The thing is that this is just one instance of a whole new dimension in using genetic testing at various phases of cancer diagnosis and treatment. What applies to breast cancer will apply to other sites as well. It will add a new dimension to decision making for clinicians and patients. It’s also opening up a growth industry for diagnostics makers and is giving pharmaceutical companies the shivers. Some chemo protocols that have been routine may need to be modified and limited.

New findings add to the evidence that genetic tests
can help predict whether breast cancer will recur, giving valuable guidance to
doctors and patients about whether potentially toxic chemotherapy will be useful
or can safely be avoided, researchers said yesterday.The findings, presented at a breast cancer conference in

San Antonio and in a paper released
by The New England Journal of Medicine, suggest that telltale genetic signatures
of tumors will in time be used to tailor treatments to individual patients. "It would probably make a difference in the treatment of tens of thousand of
women," said Dr. Robert C. Bast Jr., vice president at the M. D. Anderson Cancer
Center in Houston and
co-author of an accompanying editorial released by the journal.