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Pharmacogenomics
Week of 6 May 2026
12 articles
Geno'X Veille — genox-veille.fr
Key takeaways this week
- ►DPYD before fluoropyrimidines — severe toxicity prevention strategies (ASCO Ed Book 2026): practical recommendations for systematic testing before 5-FU/capecitabine.
- ►CYP2C19 — P2Y12 genotyping in ACS (JACC meta-analysis): 31% MACE reduction in Asian populations (allele 2/3 frequency ~30%); test recommended AHA 2024.
- ►CYP2D6/CYP2C19 in psychiatry — favorable but heterogeneous cost-effectiveness (meta-analysis 17 studies, INB +£1,623, p=0.07): standardize economic evaluation methods before generalization.
- ►Phenoconversion CYP2D6 — 48% of MDD patients affected by drug-mediated enzymatic inhibition (Frankfurt, n=35): genotype alone is insufficient, systematically check co-prescriptions.
- ►NUDT15 — global pharmacogenetic variability: exhaustive review of alleles 2 to 8, allele frequencies and clinical implications for thiopurines.
- ►WGS-PGx — validation of a clinical annotation tool for WGS pharmacogenomics implementation: high concordance with dedicated panels.
- ►CYP2C19/CYP2D6 combined — OR = 9.04 (CI 2.7–30.3) for ADRs in psychiatry in patients with dual poor metabolizer profile.
- ►CYP2D6 and antipsychotics in adolescent schizophrenia — reduced-function metabolizers show more EPS and worse quality of life: argument for preemptive genotyping in pediatric psychiatry.
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DPYD
PubMed★ Top pick
Importance of and Strategies for Implementing DPYD Testing to Prevent Severe Fluoropyrimidine Chemotherapy Toxicity
Severe fluoropyrimidine toxicity (5-FU, capecitabine, tegafur) — neutropenia, severe mucositis, death
9
/10
OncologyCPIC Level ANew recommendation
ASCO Educational Book, 2026· AprRead
CYP2C19
PubMedGenotype-Guided vs Conventional Oral P2Y12 Inhibitors in Acute Coronary Syndrome: A Combined Analysis
Acute coronary syndrome (ACS) — MACE risk under clopidogrel
8
/10
CardiologyCPIC Level ADose recommendation
JACC: Cardiovascular Interventions, 2026· FebRead
CYP2D6
PubMedEconomic effectiveness of pharmacogenomics-guided prescribing for psychiatric disorders: a systematic review and meta-analysis
Psychiatric disorders — economic efficiency of PGx genotyping
8
/10
PsychiatryCPIC Level APreemptive genotyping
The Pharmacogenomics Journal, 2026· AprRead
NUDT15
PubMedComprehensive overview of the global pharmacogenetic and functional variability in NUDT15
Thiopurine toxicity (mercaptopurine, azathioprine, thioguanine) — severe myelotoxicity
7
/10
ImmunosuppressantsCPIC Level AAdverse reaction
Human Genomics, 2026· AprRead
CYP2C19
PubMedInfluence of combined CYP2C19 and CYP2D6 phenotypes on adverse drug reactions in patients with major depressive disorder: a clinical cohort study
Major depressive disorder (MDD) — antidepressant adverse drug reactions
7
/10
PsychiatryCPIC Level APhenoconversion
The Pharmacogenomics Journal, 2026· AprRead
CYP2D6
PubMedA pilot study of pharmacogenomic testing as a tool to enhance depression care in Veterans
Depression in military veterans — implementation of multigene PGx genotyping
7
/10
PsychiatryCPIC Level APreemptive genotyping
The Pharmacogenomics Journal, 2026· AprRead
CYP2C19
PubMedIdentification and functional characterization of 11 novel CYP2C19 variants in the Chinese Han population
CYP2C19 metabolic variability — new alleles in Chinese Han population
7
/10
New interactionRecurrent variant
Pharmacogenomics, 2025· DecRead
CYP2D6
PubMedAnalytical Validation of an Annotation Tool for WGS-Based Pharmacogenomics: Preparing for Clinical Implementation
Clinical implementation of WGS for pharmacogenetics — analytical validation
7
/10
Preemptive genotyping
Clinical and Translational Science, 2026· AprRead
CYP2C19
PubMedChallenges and prospects of CYP2C19 genotype-guided clopidogrel therapy from the perspective of precision medicine
Post-PCI antiplatelet therapy — debate on CYP2C19 genotyping generalization
7
/10
CardiologyCPIC Level ADose recommendation
Frontiers in Pharmacology, 2026Read
CYP2C9
PubMedDrug-gene interactions and the risk of diabetic microvascular complications: A population-based cohort study
Diabetic microvascular complications — influence of drug-gene interactions on risk
7
/10
DiabetesAdverse reactionNew interaction
Diabetes, Obesity and Metabolism, 2026· AprRead
DPYD
PubMedDihydropyrimidine dehydrogenase (DPYD) genetic testing and treatment with 5-fluoropyrimidines in cancer patients
Cancer — prevention of 5-fluoropyrimidine toxicity
7
/10
OncologyCPIC Level ANew recommendation
Pharmacogenomics, 2026Read
CYP2D6
PubMedPharmacogenetic Variability and Quality of Life in Adolescent Patients with Schizophrenia: The Impact of Metabolizer Status, Symptom Severity, and Adverse Reactions to Antipsychotic Treatment
CYP2D6 PGx variability and antipsychotic tolerability in adolescent schizophrenia patients
7
/10
PsychiatryCPIC Level AAdverse reaction
Journal of Clinical Medicine, 2026· AprRead
References and sources
- DPYD — Severe fluoropyrimidine toxicity (5-FU, capecitabine, tegafur) — neutropenia, severe mucositis, death. ASCO Educational Book, 2026. PMID 42048619. Score 9/10. https://pubmed.ncbi.nlm.nih.gov/42048619/
- CYP2C19 — Acute coronary syndrome (ACS) — MACE risk under clopidogrel. JACC: Cardiovascular Interventions, 2026. PMID 41672687. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/41672687/
- CYP2D6 — Psychiatric disorders — economic efficiency of PGx genotyping. The Pharmacogenomics Journal, 2026. PMID 41935047. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/41935047/
- NUDT15 — Thiopurine toxicity (mercaptopurine, azathioprine, thioguanine) — severe myelotoxicity. Human Genomics, 2026. PMID 41935317. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41935317/
- CYP2C19 — Major depressive disorder (MDD) — antidepressant adverse drug reactions. The Pharmacogenomics Journal, 2026. PMID 41957345. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41957345/
- CYP2D6 — Depression in military veterans — implementation of multigene PGx genotyping. The Pharmacogenomics Journal, 2026. PMID 41980954. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41980954/
- CYP2C19 — CYP2C19 metabolic variability — new alleles in Chinese Han population. Pharmacogenomics, 2025. PMID 41640344. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41640344/
- CYP2D6 — Clinical implementation of WGS for pharmacogenetics — analytical validation. Clinical and Translational Science, 2026. PMID 41995114. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41995114/
- CYP2C19 — Post-PCI antiplatelet therapy — debate on CYP2C19 genotyping generalization. Frontiers in Pharmacology, 2026. PMID 41953196. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41953196/
- CYP2C9 — Diabetic microvascular complications — influence of drug-gene interactions on risk. Diabetes, Obesity and Metabolism, 2026. PMID 41582657. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41582657/
- DPYD — Cancer — prevention of 5-fluoropyrimidine toxicity. Pharmacogenomics, 2026. PMID 41797628. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/41797628/
- CYP2D6 — CYP2D6 PGx variability and antipsychotic tolerability in adolescent schizophrenia patients. Journal of Clinical Medicine, 2026. PMID 42074716. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/42074716/