Pharmacogenomic Biomarkers of Susceptibility to Adverse Drug Reactions: Just Around the Corner or Pie in the Sky?

Two overarching goals tied to a futuristic vision of personalized medicine are to maximize individually derived benefits from available therapeutic drugs or biological agents and identify a reliable set of predictors of toxic outcomes to optimally manage a patient's treatment-related risk. This article will primarily address the second of these goals with a specific focus on challenges faced in the development of pharmacogenomic markers that would be used by practitioners to predict individual susceptibility to serious adverse drug reactions. The potential complexity of polygenic modifiers of risk for certain adverse drug reactions and demographic diversity in the prevalence of genomic variants pose significant challenges in the development of useful predictive biomarkers. Implementing rigorous scientific and logistical strategies to address these will be crucial in order to achieve meaningful success.