The 5th International Congress of the European Society of Pharmacogenomics and Personalized Therapy (ESPT 2019) was held inSeville, Spain, from Oct. 16-18, 2019. 

The conference addressed the research progress and clinical implementation of pharmacogenomic initiatives in Europe. It brought together leading international scientists and healthcare professionals actively working in the fields of pharmacogenomics and personalized therapy. 

Altogether, 45 speakers participated in 11 sessions and covered a broad spectrum of pharmacogenomics research and clinical applications across several clinical disciplines.

Top takeaways 

• Three pharmacogenomic programs presented public health initiatives, including the Spanish MEDEA Project, the British 100,000 Genomes Project, and the multinational U-PGx program.
• Key topics covered included challenges that laboratories still face when testing for complex genes such as CYP2D6, or when testing reveals rare genetic variants. Several presentations highlighted the limited number of studies that are available for pediatrics and admixture populations. 
• The need for robust and comprehensible clinical decision-support tools to facilitate the uptake of genotype-based recommendations by healthcare providers was reinforced throughout the sessions by implementers.
• Compared to ESPT 2017, many attendees included hospital laboratory directors who have conducted proof-of-concept PGx implementation and were now looking into expanding their programs. Many asserted that PGx tests were well received by psychiatrists or physicians who care for polypharmaceutical patients.

New and interesting research findings presented at ESPT 2019

• The use of combined DPD phenotyping and DPYD genotyping to improve dosing recommendations for fluoropyrimidines.
• Dr. Mikko Niemi: The use of physiologically based pharmacokinetic modeling to better predict the risk of statin-induced myopathy when a patient has multiple genetic and non-genetic risk factors.
• Dr. Munir Pirmohamed: The HLA-B*5701, which is a well-known risk allele for Abacavir-associated hypersensitivity, was also found to be associated with carbamazepine-induced hypersensitivity in Northern and Southern Europeans. 
• Dr. Ann Daly: Although many HLA and non-HLA risk alleles have been identified as risk alleles for drug-induced liver injury (DILI), none of the associations described to date justify pre-prescription genotyping implementation. Of note, 5-10 percent of DILI results in liver failure requiring transplantation.
• Dr. Matthias Schwab: Gave a nice review of CYP2D6-genotype-guided tamoxifen prescription and presented compelling findings that indicated that poor drug adherence is also strongly associated with a lower response to tamoxifen independently of the pharmacogenomic effect.

ESPT 2019 highlighted both the progress and challenges that active PGx programs face. Sharing these successes and setbacks allows pharmacogenomics to move forward.