Finding the Right Drug

At the right dose at the right time for every patient

By Mayo Clinic Staff

Richard Weinshilboum, M.D., is director of the Pharmacogenomics Program in the Center for Individualized Medicine.

It's a question that has troubled physicians since the invention of medicine: Why does a drug work for one patient but not for another?

The answer lies in our genetic makeup, and pharmacogenomics helps uncover those answers. It's a complicated word with an easily understood premise — finding you the right drug at the right dose every time. It allows physicians to determine your response to specific drugs and drug interactions before it occurs.

"Modern drugs are very powerful agents that can do great good but also great harm," says Richard Weinshilboum, M.D., director of the Center for Individualized Medicine's Pharmacogenomics Program and the Mary Lou and John H. Dasburg Professor of Cancer Genomics.

Dr. Weinshilboum is often called "the father of pharmacogenomics," though the scientist demurs: "The only thing that I'm father of is my two children."

Supported by benefactors, his efforts laid the groundwork for three decades of Mayo Clinic's leadership in the field. His research set the stage for applying genetic variation to individualized drug treatment, and his mentorship has built one of the best pharmacogenomics teams in the world.

"Mayo is perceived as a leader because of a group of talented people here," says Dr. Weinshilboum. "Our collaborations include an entire network across the United States, including most of the National Institutes of Health, as well as international collaborations with Canada, Germany and Japan."

With continued support, Dr. Weinshilboum and the team are taking pharmacogenomics to the next stage — developing studies in areas of breast cancer (BEAUTY), prostate cancer (PROMOTE) and cardiovascular disease (TAILOR-PCI). The studies are using genotyping and whole-genome sequencing to determine treatment options both before care starts and after, tailoring the process to each individual.

And it's just the start. Recently, the Center for Individualized Medicine launched a pilot program placing genetic information in a limited number of patients' electronic medical records. The data will give physicians a deeper understanding of the patient to ensure the best possible clinical decisions.

"Eventually, every patient at Mayo will have this information embedded in their medical record," says Gianrico Farrugia, M.D., director of the Center for Individualized Medicine. "It's the intersection of genomics, computerized learning and physicians. It means even more individualized care for every Mayo Clinic patient."