Race/ethnicity and genome-based drug toxicity studies

• In Event: Trans/national Politics of Race, Racism, and Anti-Racism

Abstract

In order to arrive at the goals of precision medicine, population-based genomic studies aim to identify potentially important single nucleotide polymorphisms (SNPs) with regard to drug response. A major concern in clinical practice is to mitigate the level of toxicity of drugs on patients. Even for drugs in primary care, concerns for adverse drug reactions remain substantial. In this presentation, I discuss the inevitable tensions surrounding the usage of genetic information in deciding appropriate drugs for the patients. I examine the issues and concerns that oncologists have for collecting and using germline genetic/genomic information in reducing adverse drug reactions. Drawing on clinical level interview data with oncologists and medical scientists in Singapore, California (USA), and Vancouver (Canada) who are tasked with delivering precision medicine on the front line, I discuss when and whether certain population categories (e.g. ethnicity, race) are being used in a manner that obscures or illuminates differences in adverse drug reaction. I argue that the issues are not only about the lack of funding, but also other more fundamental factors – including, but not limited to, the social construction of race/ethnicity and the fact that adverse drug reaction is a complex trait – that contribute to a considerable lack of clinical utility of such genomic studies of cancer drug toxicity effects.

Author

• Shirley Sun, Nanyang Technological University