LAUSR

Pain relief is a basic human right.[1,2] Progress in the domain of pain management, particularly in that of cancer, is quite slow and remains as one of the feared aspects of the disease.[3] On an average, one out of three patients is not receiving pain medications appropriate to his/her pain intensity. Poor success rate of the existing pain and adjuvant therapies necessitates the need for pharmacogenomic testing in palliative care for better patient outcomes.[4,5] Newer pharmacogenomic insights in the past two decades have revolutionized the management of many diseases and have paved the way for the induction of precision medicine in the clinical management of diseases.[6] Pharmacogenomics involves the usage of pharmacogenomic testing to guide precision medicine with the ultimate goal of improving the drug efficacy and patient safety. Pharmacogenomic testing could stratify patients into various categories, such as likely responders, likely nonresponders, or likely to experience adverse drug reactions (ADRs) to a drug therapy.[7] Pharmacogenomics has evolved as a potential tool to improve the patient care in pain management.[8] Pain management medications are associated with a significant interindividual variability in the analgesic response. One of the prime reasons for this analgesic response variability is due to single-nucleotide polymorphisms (SNPs) in gene that are involved in the drug metabolism and transport.[9] Some of the genes that have gained a significant clinical interest for pharmacogenomic testing in the pain management of palliative care are cytochrome P450 2D6 (CYP2D6), cytochrome P450 2C9 (CYP2C9), ATP binding cassette subfamily B member 1 (ABCB1), cyclooxygenase-1 (PTGS1), cyclooxygenase-2 (PTGS2), opioid receptor μ (OPRM1), opioid receptor κ (OPRK1), opioid receptor δ (OPRD1), and catechol-O-methyltransferase (COMT).