Cancer and Immunosuppressive PGx Panel
Test Description
The Cancer and Immunosuppressive PGx Panel is intended for individuals undergoing cancer treatment or immunosuppressive therapy who may benefit from personalized pharmacogenetic-guided medication management. This panel evaluates clinically relevant genetic variants associated with drug metabolism, efficacy, toxicity risk, and treatment response for medications commonly used in oncology and immunosuppressive care. Pharmacogenetic testing may help guide medication selection and dose optimization, reduce the risk of adverse drug reactions and treatment-related toxicities, and support safer, more effective individualized therapy. Upon completion of testing, patients receive an interpretive pharmacogenetic report and certificate summarizing clinically relevant results and medication-related findings to support ongoing care and future treatment decisions.
Ordering Information
Preferred specimens: Saliva
Alternate specimens: Buccal SwabTesting Kit Request Form
Clinical Description
MTHFR, TPMT, CYP2D6, CYP3A4, CYP3A5, NUDT15, CYP2C9, HTR1A
Many of anti-cancer medications are under influence of genetics. Standard chemotherapy may eradicate for example breast cancer in some of affected individuals but work less effectively in others. Genetic make-up of individuals may explain the differences in drug response. In addition to cancer medications, pharmacogenetics may have implications for immunosuppressive medications. Precision prescribing of immunosuppressive medications such as tacrolimus can help with management of transplant recipients.
Frequency of Cytochrome P450 (CYP2D6) Metabolizer Types in the population
| Cytochrome | Poor metabolizer | Intermediate metabolizer | Normal metabolizer | Rapid or ultra-rapid metabolizer |
| CYP2D6 | 4-7% | 9-35% | 50-90% | 2-3% |
Tagged Genes
- Evans WE, McLeod HL. Pharmacogenomics—drug disposition, drug targets, and side effects. N Engl J Med. 2003;348(6):538–549.
- Johnson JA, Cavallari LH. Pharmacogenetics and cardiovascular disease: implications for personalized medicine. Pharmacol Rev. 2013;65(3):987–1009.
- Cavallari LH, Lee CR, Beitelshees AL, et al. Multisite investigation of outcomes with implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention. JACC Cardiovasc Interv. 2018;11(2):181–191. doi:10.1016/j.jcin.2017.07.022
- Jneid H, Anderson JL, Wright RS, et al. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non–ST-elevation myocardial infarction. Circulation. 2012;126(7):875–910. doi:10.1161/CIR.0b013e318256f1e0
- Scott SA, Sangkuhl K, Stein CM, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther. 2013;94(3):317–323. doi:10.1038/clpt.2013.105
- Johnson JA, Caudle KE, Gong L, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. Clin Pharmacol Ther. 2017.
- Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial. Lancet. 2010;376(9753):1658–1669. doi:10.1016/S0140-6736(10)60310-8
- The SEARCH Collaborative Group. SLCO1B1 variants and statin-induced myopathy—a genomewide study. N Engl J Med. 2008;359(8):789–799. doi:10.1056/NEJMoa0801936
- Clinical Pharmacogenetics Implementation Consortium (CPIC). Genes–drug pairs.
- U.S. Food and Drug Administration. Table of pharmacogenomic biomarkers in drug labeling.