HGM 2011 - Dubai, UAE

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Howard L. McLeod

Title: LEARNING HOW TO APPLY THE GENOME TO GUIDE THERAPY

The field of pharmacogenomics has seen some exciting advances in the recent past. The Human Genome Project and International HapMap projects have uncovered a wealth of information for researchers. This has lead to the discovery of clinically predictive germline genotypes (e.g. UGT1A1*28-irinotecan, TYMS TSERfluoropyrimidines, CYP2D6-tamoxifen, CYP2C19-clopidogrel), germline haplotypes (e.g. VKORC1 Haplotype A-warfarin) and somatic mutations (e.g. epidermal growth factor receptorgefitinib/ erlotinib, KRas-cetuximab/panitumumab). The introduction of FDA approved pharmacogenetic tests (UGT1A1*28, CYP2C9/VKORC1, CYP2D6/CYP2C19) and the initiation of genotype-guided clinical trials have provided the first steps towards the integration of pharmacogenomics into clinical practice. However, it is also clear that there are many scientific and non-scientific barriers to clinical application. These include integration of new tests into health systems, changing old habits to allow application of new data, and the reality that the cost of both testing and the therapeutic options are a key driver in health care.
As the scientific evidence matures, A team research approach must be more aggressively applied in order to overcome the many obstacles to delivering more careful selection of drug therapy.

Sheikh Hamdan Bin Rashid Al Maktoum
Award for Medical Science

Human Genome Organisation

Centre for Arab Genomic Studies