This project looks for genetic changes in people taking medications for symptoms related to incurable illness, with the aim of improving symptom control by providing personalised prescribing guidance based on genetic profile.
Background
People living with terminal or life limiting conditions such as incurable cancer often have problems with pain, vomiting and other symptoms which impact quality of life. Supportive and Palliative Care aims to improve the symptoms of people with terminal conditions, particularly towards the very end of life. There are many drugs that can be used to help with these symptoms, but often they do not work, or they cause side effects for the people taking them. “Pharmacogenomics” is a way of predicting who is more likely to have a good response to drugs, and who is more likely to get side effects, based on their genes. We know that changes in certain genes (as happens naturally in the population) might mean that a drug might not work as well for some people as others. We are interested in whether testing for these differences in genes for people living with cancer and experiencing symptoms, might help improve their care, and how to provide feedback from these test results to the clinicians involved in patient care.
Project Aims
To understand whether performing a genetic test for patients receiving palliative and supportive care could impact prescribing practice where interactions between drugs prescribed and a person's genetic profile have been identified.
Project Activity
- All participants will undergo testing of a panel of genetic variants relevant to drugs used in symptom control (see https://cpicpgx.org/genes-drugs/). This will involve collecting a 5mL blood sample (the intervention) from individuals. All participants will be consented to examination of their records within local hospitals and/or primary care to extract study relevant data.
- The start of follow-up will be from the date of the blood sample (the intervention). Standard demographic information including ethnicity will be collected at baseline.
- Participation in study will be for the duration of being under palliative care treatment, up to a maximum of 90days from recruitment data.
Anticipated outputs
The learning from this study will inform a large scale grant application. Outputs will include publication of findings in peer-reviewed journals and a report summarising findings.
Papers/resources associated with this project
Barry C, Patel M. Pharmacogenomics and symptom management in palliative and supportive care: A scoping review. BMJ Support Palliat Care. 2025 Jan 13:spcare-2024-005205. doi: 10.1136/spcare-2024-005205. Epub ahead of print. PMID: 39805678.
Who is involved?
- Dr Martyn Patel, Chief Investigator, Consultant Geriatrician (NNUH)
- Dr Caroline Barry, Co-Chief Investigator, Consultant Palliative Medicine (NNUH) and University of East Anglia (UEA)
- Professor William Newman – Co-Investigator, Professor of Translational Genomic Medicine in The Manchester Centre for Genomic Medicine (MCGM) at the University of Manchester and Honorary Consultant at Manchester University NHS Foundation Trust (MUH)
- Dr John McDermott – Co-Investigator, Clinical Geneticist (MCGM at MUH
- Mrs Roberta Lovick: PPI Lead
