Dr. Kasi on the Application of Pharmacogenomics in CRC

Pashtoon M. Kasi, MD, MBBS, MS, assistant professor of oncology and senior associate consultant in the Division of Hematology/Oncology at Mayo Clinic, discusses the application of pharmacogenomics in colorectal cancer (CRC).

Genetic testing is underutilized in CRC, says Kasi, although it can help guide treatment decisions based on the mutations or variations a patient may present with. For patients with CRC, it is known that certain genes metabolize 5-fluorouracil or capecitabine. Moreover, physicians are familiar with the drugs that metabolize irinotecan chemotherapy. Historical analyses have shown that these patients fare worse in terms of toxicity when they receive chemotherapy and harbor an aberration in one of these genes, he adds.

Incorporating this testing into practice is viable, says Kasi. Now, test results come back within 3 to 5 days which enables physicians to make treatment decisions in real-time. Additionally, there are guidelines that show how much chemotherapy a patient should be given if they have an aberration in a certain gene.