Pharmacogenomics in Personalized Medicine: A Systematic Review of Gene-Drug Interactions and Clinical Outcomes
Keywords:
Pharmacogenomics, Pharmacogenetics, Personalized Medicine, Adverse Drug Reactions, CYP450 Polymorphisms, Gene-Drug Interactions, Clinical Decision Support, Preemptive GenotypingAbstract
Pharmacogenomics — the study of genetic variation and its influence on drug response — has ushered in a paradigm shift in clinical pharmacology with the potential to provide therapeutic treatment personalized to a patient's genetic architecture. Although sequencing technologies and pharmacogenomic databases have advanced substantially, the conversion of genotype to clinical relevance remains non-homogeneous across healthcare systems worldwide. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and CINAHL databases for publications from January 2020 to April 2025, screened according to PRISMA guidelines and relevant to pharmacogenomic biomarkers, gene-drug interactions, clinical implementation, and patient outcomes. Abundant evidence supports the clinical value of pharmacogenomic-guided therapy in oncology, psychiatry, cardiology, and infectious disease. Validated variants including CYP2C19, CYP2D6, TPMT, DPYD, HLA-B*57:01, SLCO1B1, and VKORC1 enable actionable clinical decision-making. Preemptive pharmacogenomic testing integrated with electronic health record clinical decision support reduces adverse drug reaction incidence, improves prescribing guideline concordance, and generates measurable cost savings. Systematic pharmacogenomics integration into clinical workflows through comprehensive clinical decision support systems and structured educational programs represents the most scalable strategy to realize precision medicine at the bedside.
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Copyright (c) 2026 Jeremy Mytskevych (Author)
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