Leading Article

Pediatric Drugs

, Volume 15, Issue 2, pp 71-81

First online:

Cancer Pharmacogenomics in Children: Research Initiatives and Progress to Date

  • Shahrad Rod RassekhAffiliated withDepartment of Pediatrics, Division of Pediatric Hematology/Oncology/BMT, University of British ColumbiaChild and Family Research Institute, British Columbia’s Children’s HospitalDivision of Pediatric Hematology/Oncology/BMT, BC Children’s Hospital Email author 
  • , Colin J. D. RossAffiliated withChild and Family Research Institute, British Columbia’s Children’s HospitalDepartment of Pediatrics, Division of Translational Therapeutics, University of British ColumbiaDepartment of Medical Genetics, University of British Columbia
  • , Bruce C. CarletonAffiliated withChild and Family Research Institute, British Columbia’s Children’s HospitalDepartment of Pediatrics, Division of Translational Therapeutics, University of British Columbia
  • , Michael R. HaydenAffiliated withDepartment of Medical Genetics, University of British ColumbiaCentre for Molecular Medicine and Therapeutics, University of British Columbia

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Abstract

Over the last few decades, cure rates for pediatric cancer have increased dramatically, and now over 80 % of children with cancer are cured of their disease. This improvement in cure has come with a significant cost, with many children suffering irreversible, life-threatening, or long-lasting toxicities due to the medications required during their treatment. In the last 2 decades, major technological advances in genomics and the mapping of the human genome have made it possible to identify genetic differences between children in order to investigate differing responses to cancer therapy and to help explain why children treated with the same medications can have different outcomes. The emerging field of pharmacogenomics has had many important findings in pediatric cancer. The focus of this review is drug toxicity in pediatric cancer and the use of pharmacogenomics to reduce these adverse drug reactions, with a specific focus on thiopurines, methotrexate, cisplatin, vincristine and anthracyclines. Future areas of research and the need for international collaboration are discussed.