Personalizing Colorectal Cancer Care: Opportunities for Pharmacogenomics

Abstract

A diagnosis of metastatic colorectal cancer impacts nearly 30,000 Americans a year, and while treatments are available, they come with the risk of morbidity and mortality. Personalized medicine, the use of an individual’s genetic information to tailor their treatment, is used in oncology to determine somatic, druggable targets to select therapy. It also provides an opportunity to understand the likelihood that an individual would develop toxicities during treatment or fail to respond to treatment. This approach has not been integrated into clinical practice at the same level as the targeted approach. This dissertation explores the opportunities for germline pharmacogenetic testing to inform chemotherapy and non-chemotherapy medication selection in a historical cohort of Americans with metastatic colorectal cancer and models the theoretical cost-effectiveness of implementing this approach.