Ancestry-aware pharmacology: drug-level sub-studies across populations before approval
Drugs are processed differently by people with different genetic backgrounds, but doses are set mostly in white and East Asian populations. Every new drug should be studied for how it behaves across ancestries, with dosing advice by genotype rather than by race.
Registrational programmes include pharmacokinetic and pharmacogenomic sub-studies powered across major genetic ancestry groups, genotyping known variants (CYP2D6, CYP3A5, UGT1A1, DPYD, NUDT15, HLA alleles) and reporting exposure and toxicity by genotype. Labels carry genotype-based dosing where exposure differs, replacing crude race-based statements. African, South Asian and Indigenous populations are prioritised because they are least represented in existing PK data.
- Trials do not represent the people who get cancer · Older, Black, Hispanic, Asian, rural, poor and multimorbid patients are under-represented, so results may not apply to them.
- Wrong doses · Most drug doses were chosen as the highest a person can tolerate, which is often more than they need.
Pages like this
not linked directly; found by shared links- IdeaBuild polygenic scores that work in every ancestry before deploying any
Shares Germline (hereditary) testing, Trials do not represent the people who get cancer.
- IdeaLet clinics contact relatives directly when a cancer gene is found
Shares Germline vs somatic mutations, Germline (hereditary) testing.
- IdeaA mandatory over-70s cohort with geriatric assessment in every pivotal trial
Shares Wrong doses, Trials do not represent the people who get cancer.
- IdeaAnalyse and dose by sex: women get more toxicity from many cancer drugs at the same dose
Shares Wrong doses, Trials do not represent the people who get cancer.
- CollectionClinVar
Shares Germline vs somatic mutations, Germline (hereditary) testing.
- IdeaAutomatic germline testing for every cancer type where it changes care
Shares Germline vs somatic mutations, Germline (hereditary) testing.
- IdeaTest DPYD, UGT1A1 and TPMT/NUDT15 before the first dose, everywhere
Shares Wrong doses, Germline (hereditary) testing.
- IdeaUniversal tumour and germline sequencing at diagnosis feeding a shared learning system
Shares Germline vs somatic mutations, Germline (hereditary) testing.