This is the first time this topic has been explored in the UK.

Pharmacogenomics is a potential tool to use in personalised medicine, studying how our genes affect how we respond to medicines, which can be used to guide individualised prescribing.

Dr Caroline Barry and Dr Martyn Patel began to explore the area due to a shared interest in medicines optimisation, and the need to improve symptom management across end-of-life care. They decided to carry out a review to question whether pharmacogenomics, a tool to assess our genes, can help clinicians choose the best medicines to manage symptoms for palliative care patients.

During their review they found that many of the medications used in palliative care may be susceptible to drug-gene interactions, which may impact how effective those medications are at managing symptoms. The review was published in the latest issue of BMJ Supportive and Palliative Care and selected as Editors’ Choice.

Dr Barry, Consultant in Palliative Care, said: “Through our scoping review we found that it is both feasible and acceptable to test people’s genes in palliative care, however more clinical trials are needed to see if pharmacogenomics can improve symptom management for people receiving palliative and supportive care.”

The importance of this work has been recognised by the NHS Pharmacogenomics Network of Excellence who have funded NNUH to undertake further work in this area in collaboration with researchers from the Manchester Centre for Genomic Medicine.

Dr Patel, Consultant in Older People’s Medicine and Head of the UEA Medicines Optimisation Group, added: “We are due to start an observational trial called PISCES in this area to carry out genetic testing, which will help gather evidence on the prevalence of genes that interact with common symptom control medication, recruiting patients under the supervision of palliative care teams at NNUH. We are very grateful for all the assistance from the NNUH Research and Development team in reaching this step.”

Dr Bernard Brett, Medical Director, added: “Congratulations to Dr Patel and Dr Barry for succeeding in gaining funding for this important project. Genomics will enable us to develop personalised treatment plans for our patients, with the optimal medications and doses and has the potential to transform patient care for those with a wide variety of conditions. Palliative care always needs a personalised approach to meet our patients’ needs and pharmacogenomics is an important area of research to enable us to optimise the drugs we use to reduce symptoms.”

• Read the full research paper on Pharmacogenomics and symptom management in palliative and supportive care
• Visit the webpage for more information on the PISCES trial.