Precision medicine and pharmacogenetics: what does oncology have that addiction medicine does not?

Henry R. Kranzler, Rachel V. Smith, Robert Schnoll, Afaf Moustafa, Emma Greenstreet-Akman

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background and aims: Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation. We also considered why progress in this effort has lagged in addiction medicine. Methods: We compared the development of pharmacogenetic biomarkers in oncology, cardiovascular medicine (where developments are also promising) and addictive disorders. Results: The first major reason for the success of oncologic pharmacogenetics is ready access to tumor tissue, which allows in-vitro testing and insights into cancer biology. The second major reason is funding, with cancer research receiving, by far, the largest allocation by the National Institutes of Health (NIH) during the past two decades. The second largest allocation of research funding has gone to cardiovascular disease research. Addictions research received a much smaller NIH funding allocation, despite the major impact that tobacco use, alcohol consumption and illicit drug use have on the public health and healthcare costs. Conclusions: Greater support for research on the personalized treatment of addictive disorders can be expected to yield disproportionately large benefits to the public health and substantial reductions in healthcare costs.

Original languageEnglish
Pages (from-to)2086-2094
Number of pages9
Issue number12
StatePublished - Dec 2017

Bibliographical note

Funding Information:
The preparation of this paper was supported by NIH grants R01 AA021164, R01 AA023192 and R01 CA184315 and the VISN 4 Mental Illness Research, Education and Clinical Center at the Crescenz VAMC in Philadelphia.

Publisher Copyright:
© 2017 Society for the Study of Addiction


  • Addiction medicine
  • cardiovascular medicine
  • oncology
  • personalized medicine
  • pharmacogenetics
  • precision medicine
  • stratified medicine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health


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