Abstract

Pharmacogenomics leverages genomic information to optimize drug therapy, improving efficacy and minimizing 
toxicity in oncology patients. Whole-exome sequencing (WES) provides a comprehensive platform for identifying 
clinically actionable variants in germline and tumor DNA, enabling personalized treatment selection and dose 
adjustment. WES-based pharmacogenomic workflows encompass patient selection, informed consent, sample 
acquisition, sequencing, variant annotation, clinical reporting, and integration into multidisciplinary care. 
Evidence indicates that pharmacogenomic-guided therapy can reduce adverse drug reactions, maintain 
chemotherapy dose intensity, and enhance targeted therapy outcomes. Economic analyses suggest potential cost 
savings through the prevention of drug-related complications, though formal cost-effectiveness remains context
dependent. Despite technical and methodological challenges, WES-guided pharmacogenomics represents a 
promising approach to precision oncology, with ongoing data accumulation likely to expand its clinical utility and 
integration into routine care.