Ten years at the forefront of personalized medicine: from achievements to future transformation

This article is dedicated to the 10th anniversary of the journal “Pharmacogenetics and Pharmacogenomics” and presents a comprehensive analysis of the evolution of the discipline. The article covers historical milestones: from the description of the first pharmacogenetic phenomena and the discovery of cytochrome P450 in the mid-20th century to modern multiomic approaches integrating genomics, transcriptomics and proteomics. Particular attention is paid to the contribution of the journal, which published 242 scientific papers that transformed data on polymorphisms of key genes (CYP2D6, VKORC1, DPYD) into clinical algorithms. Systemic barriers to the implementation of pharmacogenetics in Russia are analyzed: limited use in clinical practice, persistently high cost of NGS sequencing, and the lack of uniform regulatory standards. Much attention in the articles is paid to "ethnopharmacogenetics" — the study of the frequencies of pharmacogenetic markers in the indigenous peoples of Russia, which is important for prioritizing the implementation of certain pharmacogenetic tests in different regions. The prospects for the development of pharmacogenetics include the creation of a National DNA Biobank and a register of patients with an “inadequate” pharmacological response, the development of models for predicting and personalizing pharmacotherapy taking into account pharmacogenetic markers, as well as their clinical validation and “packaging” in a system for supporting medical decision-making, which should be constantly updated based on new research results collected in the National Pharmacogenetic Research Knowledge Base. All this would be impossible without the development of pharmacogenetic test systems available for use in medical organizations in the country, as well as the formation of relevant competencies in doctors and other healthcare professionals. The future lies in integrating pharmacogenetics into comprehensive and large-scale clinical and pharmacological counseling of patients, including using telemedicine.