ABSTRACT
Recent achievements in molecular genetics have led to a substantial accumu-
lation of knowledge about the mechanisms of interindividual variability in
drug response. According to a recent report of the British Department of
Health, the greatest impact of novel genetic tools and technologies will be real-
ized in the field of pharmacogenomics (1). Pharmacogenomics is set to
provide a relevant contribution to our understanding of adverse drug reactions
and non-responsiveness to drug therapy. The most intriguing application of phar-
macogenomics in drug treatment will likely change the way in which we apply
drugs to routine care. It is widely proposed that genetic information of individuals
could be used to avoid “trial-and-error” scenarios during medication. Based on
genotype-based dose recommendations, medicine is expected to evolve from
the commonly used “one dose fits all” strategy to a patient-tailored drug selection
and dose optimization. So far, however, most promises related to the vision of
individualized therapies have remained unfulfilled. The greatest challenges for
the field of pharmacogenomics relate to the issues of genotype-phenotype and
genotype-environment interactions, optimal selection of study designs, predic-
tivity and ethical aspects. Besides other factors, such as drug interactions or
poor compliance, pharmacogenetic variability constitutes a potentially relevant
factor for drug response variability. Although its current impact on the routine
of medicine is minimal, pharmacogenomics might, thus, provide useful contri-
butions to the future practice of drug therapy.
