Pathologists across Australia are advocating for greater access to blood tests that can identify patients who may experience life-threatening reactions to certain medications, including codeine and chemotherapy. The call comes in response to the experiences of patients like Jennifer Kohne, who suffered from severe side effects due to her body’s inability to metabolise chemotherapy tablets during her treatment for bowel cancer.
A DPYD test identified a genetic variant in Kohne’s DNA that caused her adverse reaction to the common chemotherapy drug, Capecitabine. Medical Oncologist Dr. Cassandra White expressed concern over the frequency of such incidents, stating that 1% of patients die from side effects related to their chemotherapy, not their cancer.
The Royal College of Pathologists (RCPA) is pushing for better funding for pharmacogenomic testing, a procedure that can identify which patients are at risk of severe reactions to medications. The RCPA currently has two applications before the Medical Benefits Advisory Committee to consider rebates for two genetic tests for chemotherapy and anti-seizure medication.
Pharmacogenomic testing, according to Dr. White, is already standard practice across Europe and the UK. Professor Luke Hesson from the RCPA’s Pharmacogenomic Advisory Committee backs up her claim, adding that preventing patients from hospitalisation due to adverse reactions also makes economic sense.
“These tests range in cost from around $80 to $200… hospitalisation due to these adverse reactions can cost tens of thousands of dollars,” Hesson said.
The RCPA has highlighted 35 medications where pharmacogenomic testing can predict side effects or therapy failure, including common antidepressants, pain relievers, neurological medications, cholesterol-lowering drugs, and blood thinners.
Pre-exposure testing is recommended by experts and international regulatory bodies for 12 of the 35 medications listed. Thus, oncologists and psychiatrists in Australia are leading the way in adopting this testing regime, hoping to prevent future patient suffering and potentially save lives.
