PGx: Knowledgebase
Workflow for Oncology Solution
Drug-Metabolizing Enzyme
45
Drug Trasporter
27
High Risk Gene for Drugs
10
Drug Target
59
Other Genes
100+
Sample Requirements
- Peripheral blood (3-5 ml), EDTA anticoagulant tube, slightly reverse blood vessel collection for 5-10 times.
- If the sample is not tested immediately, it should be stored in the refrigerator at 2-8°C, no more than 120 hours.
- 2-8°C cold chain transportation, sample should arrive within 72 hours to the laboratory
PGx- Panel Information
| Single Panel | Drug Classification |
|---|---|
| Aspirin, Clopidogrel, Statins, Warfarin | Cardiovascular |
| Folic Acid | Supplements |
| Azathioprine, Glucocorticoids, Cyclophosphamide, Tacrolimus, Mycophenolate mofetil, Cyclosporin | Immunosuppressant |
| Omeprazole, Lansoprazole, Pantoprazole | Gastrointestinal |
| Fluorouracil, Irinotecan, Platinum, Methotrexate, Capecitabine | Antineoplastic |
| Sertraline | Antipsychotic |
| Voriconazole | Antifungal |
| Nitroglycerine | Vasodilators |
| Alcohol Dehydrogenase | Metabolism |
| Single Panel | Drug Classification |
|---|---|
| Aspirin, Clopidogrel, Statins (Pravastatin, Simvastain, atorvastatin etc) | Antiplatlet/Anticoagulants/Antihypercholesterolemia |
| Sulphonylurea (Glibenclamide, Glimepride etc), Thiazolidinediones (Rosiglitazone, Pioglitazone etc), DPP4 (Sitagliptin etc) | Antidiabetic |
| Morphine, Fentayl, Codeine, Oxycodone, Methadone, Sufentanil | Opioids |
| Tacrolimus, mycophenolate, cyclosporin, glucocorticoids | Immunosuppressant |
| CCB (eg. Amlodipine, Nifedipine), Diuretic (eg Furosemide), Sartans, ACE inhibitors | Cardiovascular |
| Amitriptyline, Clomipramine, Clozapine, Desipramine, Doxepin, Imipramine, Nortriptyline, Trimipramine, Paroxetine, Mirtazapine, Fluvoxamine, Escitalopram, Duloxetine, Citaloprim, Tomoxetine | Antipsychotic |
PGx Clinical Implementation System
- Accept data from various platforms in different formats
- Scheduled data syncing and batch processing
- Automatic QC and bioinformatics analysis
- Informative data visualization and variant assessment
- Integrative lab reporting functions
- Seamless integration with the LIMS system
Classification of Clinical Recomendation / Evidance
(Sample Report)
 |
Aspirin, Clopidogrel, Statins, Warfarin |
 |
Folic Acid |
 |
Azathioprine, Glucocorticoids, Cyclophosphamide, Tacrolimus, Mycophenolate mofetil, Cyclosporin |
 |
Omeprazole, Lansoprazole, Pantoprazole |
 |
Fluorouracil, Irinotecan, Platinum, Methotrexate, Capecitabine |
|
Patient may have adverse event |
|
Patient may benefit from dosage increasing |
|
Patient may benefit from dosage decreasing |
|
1. The drug may have minor toxicity effect or be less effective for the patient 2. The patient carries genetic variation that significatntly alters the fuction of assosiacitad gene (ultrarapid or poor metabolizer, poor function, unfavourable genotype, positive for risk allele, etc.), thus, drug metabolism and / or drug response ware affected. However, clinical evidence on patient response is lacking |
|
Genetic variation of minor clinical significanse was detected |
Result Summary
| DRUG | CLINICAL RECOMMENDATION / EVIDENCE | |
|
Phenytoin | Decrease dosage |
|
Oxcarbazepine | Use drug as label |
|
Lamotrigine | Use drug as label |
 |
Valproic Acid | May decrease dosage |
|
Clobazam | May decrease dosage |
|
Carbamazepine | Possible adverse events |
|
Phenobarbital | May be less effective |
Test Result
| Clinical Action |
Drug | Gene | Genotype | Phenotype | Drug Response | Evidance Level |
||
|---|---|---|---|---|---|---|---|---|
| Toxicity | Dosage | Efficacy | ||||||
|
Phenytoin | CYP2C9 | *1/*3 | Intermediate motabolizer |  |
 |
- | L1 |
| HLA-B *1502 | - | Negative | - | - | - | L1 | ||
| CYP2C19 | *1/*2 | Intermediate metabolizer | - | |
- | L3 | ||
|
Valproic Acid | CYP2C9 | *1/*3 | Intermediate metabolizer | |
|
- | L2-b |
|
Clobazam | CYP2C19 | *1/*2 | Intermediate metabolizer | - | |
|
L2-b |
Clinical Recomendation by Guideline
PHENYTOIN
Clinical Recommendation | Decrease Dosage (25%)
| Guideline | Phenotype/Genotype | Implication & Recommendation |
|---|---|---|
| CPIC | CYP2C9 Intermediate Metabolizer HLA-B*1502 Negative | Reduce phenytoin metabolism. Higher plasma concentrations will increase probability of toxicities. Consider 25% reduction of recommended starting maintenance dose. Subsequent maintenance doses should be adjusted according to therapeutic drug monitoring and response. |
| DPWG | CYP2C9*1/*3 | Clinical effect (S): long-standing discomfort (>168 hr), permanent symptom or invalidating injury e.g. failure of prophylaxis of artial fibrillation; venous thromboembolism; decreased effect of clopidogrel on inhibition of platelet aggregation; ADE resulting from increased bioavailibility of phenytoin; INR > 6.0; neutropenia 0.5-1.0x109/I; leucopenia 1.0-2.0x109/I; thrombocytopenia 25-50x109/I; severe diarrhea. Standard loading dose. Reduce maintenance dose by 25%. Evaluate response and serum consentration after 7-10 days. Be alert to ADEs (e.g., ataxia, nystagmus, dysarthria, sedation). |
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