REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicCommunity Series in Biomarkers in the Era of Cancer Immunotherapy: Zooming in from Periphery to Tumor Microenvironment, Volume IIIView all 11 articles
Significance and Challenges of Immunopharmacogenomics
Provisionally accepted
Lara Hanci Handzha
Yusuke Nakamura*- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
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Pharmacogenomics traditionally examines how inherited genetic variations influence drug metabolism, pharmacodynamics, and toxicity. Recent advances have highlighted the immune system as a critical determinant of therapeutic efficacy and safety. Immunopharmacogenomics integrates genetic information, particularly HLA polymorphisms and immune repertoire dynamics of T-cell and B-cell receptors (TCRs and BCRs), to explain interindividual differences in drug responses, immune-related toxicities/diseases. This review summarizes how HLA diversity, immune repertoire heterogeneity, and tolerance mechanisms shape therapeutic outcomes across diverse clinical contexts, including immune-mediated adverse drug reactions, cancer immunotherapy, graft-versus-host disease, autoimmune disorders, food allergy, transplantation, and vaccination. Emerging evidence indicates that immune repertoire sequencing captures dynamic clonal shifts and diversity alterations associated with disease states and treatment responses, providing both mechanistic insight and predictive biomarkers. By integrating genetic and immune repertoire analyses, immunopharmacogenomics establishes a framework for individualized prediction, safer drug design, and more precise immunotherapies, thereby advancing the next phase of precision medicine.
Keywords: Immunopharmacogenomics, HLA, tcr, BCR, precision medicine
Received: 24 Sep 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Hanci Handzha and Nakamura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yusuke Nakamura, yusuke-nakamura@nibn.go.jp
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