Backbone:  Gemcitabine is an anticancer drug routinely used to treat diverse cancers disease. Discontinuation of Gemcitabine based treatments is mostly caused either by toxicity or more often for tumor progression, potentially compromising patient benefit. Several strategies to prevent toxicity/resistance have been so far investigated.

Content: In order to overreach this life-conditioning side effect, we describe in detail recent findings about the underlying mechanism of genetic variants associated with toxicity and resistance to Gemcitabine-based chemotherapy. A comprehensive panel of 6 polymorphisms detected on 4 genes, previously validated as significant markers related to toxicity/resistance, arer proposed and finely described. In addition, an early outline evaluation of the genotyping costs and methods are taken in consideration.

Summary: Based on the individual pharmacogenomics profile, the oncologists will have  new means to make treatment decisions for their patients in order to maximize benefit and minimize toxicity. Based on this purpose, the clinician and lab manager should cooperate to evaluate advantages and limitations, in terms of costs and applicability, of the most appropriate pharmacogenomics tests to incorporate routinely into clinical practice.