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For a number of drugs used to treat childhood cancers, genetic variation in the drug metabolizing enzymes such as TPMT is widely recognized as important to optimal dosing and prevention of toxicity. Interestingly, newly developed small molecule based targeted agents are metabolized by a drug metabolizing enzyme known as CYP3A4. This presentation will present case examples relating to the importance of pharmacogenetic testing for some traditional chemotherapeutic agents, as well as provide an outline of potential toxicity or loss of efficacy for CYP3A4-dependent targeted agents.
Richard B. Kim, MD, FRCPC
Professor and Chair, Division of Clinical Pharmacology
Department of Medicine, Western University
Dr. Richard Kim received his medical degree from the University of Saskatchewan in 1987. After completing an internship and residency training in internal medicine, he went on to carry out fellowship training in clinical pharmacology at Vanderbilt University from 1991-1994, and then remained at Vanderbilt as a faculty member in clinical pharmacology. By 2004 he rose to the rank of tenured full Professor and was recruited to Western University from Vanderbilt University in 2006. Dr. Kim holds the Wolfe Medical Research Chair in Pharmacogenomics at Western. He has been actively leading a program of excellence in personalized medicine. In 2008, he started the first personalized medicine clinic in Canada and since 2011, personalized medicine inpatient consultation service has been available for patients who are at risk for toxicity or sub-therapeutic benefit from a number of drugs in clinical use whether for children or the elderly, for cardiovascular disease, inflammatory conditions or cancer.