Pharmacogenomics in Practice: Tacrolimus and Beyond

In this episode of The mTOR You Know, we dive into the evolving role of pharmacogenomics in solid organ transplantation with a focus on tacrolimus andCYP3A5. Our expert panel—Jennifer Trofe, Amy Pasternak, and Shirley Tsunoda—share insights on clinical trial data, guideline perspectives, and real-world application of genotype-guided dosing. We explore the benefits and limitations of CYP3A5 testing, touch on other transplant medications with pharmacogenomic considerations, and discuss barriers such as cost, access, and implementation. The conversation also highlights national survey findings,cost-effectiveness analyses, and strategies for integrating pharmacogenomics into clinical practice.Literature/Resources mentioned:ASERTAA TrialAssessing the Utility of a Genotype-Guided Tacrolimus Equation in African American Kidney Transplant Recipients Publications discussing benefits of CYP3A5 testing: 1. Anutrakulchai et al, 2. Lloberas et al, 3. Thervet et alCPIC® Guideline for Tacrolimus and CYP3A5Survey of the utilization of genotype-guided tacrolimus management in United States solid organ transplant centersNational survey of physicians' perspectives on pharmacogenetic testing in solid organ transplantationStakeholder perspectives of the clinical utility of pharmacogenomic testing in solid organ transplantationCost-benefit analyses of CYP3A5 testing for tacrolimus in transplant recipients: 1. Deininger et al, 2. Pasternak et al, 3. Wang et al, Decoding Pharmacogenomic Test Interpretation and Application to Patient Care