Can pharmacogenomics transform personalized medicine into routine clinical practice? Current evidence and future directions

Abstract

Personalized medicine (PM) represents a transformative approach in healthcare, particularly in oncology, by tailoring treatments to individual genetic, molecular, and clinical profiles, thereby improving therapeutic specificity and minimizing adverse effects. A key component of this approach is pharmacogenomics (PGx), which examines the influence of genetic variations on drug response to optimize drug selection, dosing, and safety while reducing adverse drug reactions. This review highlights recent advances in molecular biology, PGx, and molecular diagnostics that enable accurate cancer subtype classification and the development of targeted therapies. A structured literature search was conducted to identify studies on genotype-guided therapies, pharmacogenomic biomarkers, molecular diagnostics, and clinical trials evaluating treatment efficacy and interpatient variability across diverse populations. The review emphasizes the role of predictive biomarkers and pharmacogenomic profiling in addressing heterogeneity in treatment response, facilitating individualized therapeutic strategies, and improving clinical outcomes. Despite significant progress in biological therapies and precision oncology, challenges related to biomarker validation, clinical implementation, accessibility, and cost remain. Continued multidisciplinary research and large-scale collaborative studies are essential to strengthen the clinical translation of PGx and PM. The integration of PGx, molecular diagnostics, and targeted therapies is expected to further advance precision oncology and improve patient outcomes worldwide.