Studio guest: Professor Julia Kirchheiner, pharmaco-genetist

- Genetic testing for the right individual dose of medication -
Professor Julia Kirchheiner from the Institute of Pharmacology of Natural Products & Clinical Pharmacology at the University Clinic in talks with Tomorrow Today about personalized medicine.
DW-TV: We’ve known that people react differently to medication: so why do we still not have personalized medicine? Who is putting on the brakes?


Julia Kirchheiner: We have it already, and clinicians of course take into account the body mass index, gender or other factors. The only thing that we pharmaco-genetists would add is to perform a genetic test before giving the right dose to the patient.


DW-TV: Do we have to fear in the future that the doctors will look at the genes and not at the patient?


Julia Kirchheiner: I don't hope the doctors will forget to look at the patient themselves. Why should they? It's just an additional tool you have on factors which are invisible.


DW-TV: How does that actually proceed in the future? You come up to the doctor and he'll say well that's your medication, but first we have to go for a genetic test.


Julia Kirchheiner: Well not for every medication. You would never do a genetic test for taking a drug for a headache. But for long term drug therapies where the patient would like to know whether they will be responders or not it might be useful to perform a genetic test in order to better ensure efficiency in the patients.


DW-TV: And which are the fields you are looking at?


Julia Kirchheiner: I mean for the first cancer therapy you wouldn't want to lose time for treating a cancer patient and other long term treatments like depression treatment where you would like to know whether the drug actually helps.


DW-TV: What are the genes you are looking at? We all have so many different genes so which are the ones you focus on?"


Julia Kirchheiner: They are very different in pharmaco-genetics too. In principle every gene which can be involved in drug action can be a pharmaco-genetic important gene. But generally most important are drug metabolism genes, because if they are inactive they are inactive for a couple of drugs, so this is a factor influencing many drug therapies in a patient.



DW-TV: But we'll still be using the same type of medicines in the future. There will not be an infinite amount of different substances.


Julia Kirchheiner: Probably not. If you ask the industry they will tell you this is too expensive. But we can dose the medications we have in the best interests of the patients.


DW-TV: What about the pharma industry? Not that I am so worried about their profits. The pharma industry is always looking for blockbusters: Medication that can be sold to as many patients as possible: personalized medicine means the opposite.


Julia Kirchheiner: It has become more familiar to the pharma industry because they lost a lot of drugs that were taken from the market because of side effects. And these side effects happened in some single patients. And if they had known that these single patients would not tolerate the drug they would be happy and they could make their drugs more effective and safer in some populations.


DW-TV: So they are actually welcoming the personalized medications?


Julia Kirchheiner: Well they start to of course. Traditionally they opposed it and though their drug helps everybody. But they are learning that we differ and there are different patient groups who will not respond in the same way.


DW-TV: And if we look at other countries, poorer countries who do not have sufficient medication at all...isn't that just a luxurious problem we have here in the West?


Julia Kirchheiner: So far as they have any medication it would be important to make the medication as effective as possible and there are also studies ongoing on HIV treatment and tuberculosis treatment where we use pharmaco-genetic tests in order to ensure the same efficiency in all patients.


(Interview: Ingolf Baur)