Considerations for Implementing Precision Therapeutics for Children

Research output: Contribution to journalArticle


  • Matthew J. McLaughlin
  • Jonathan Wagner
  • Valentina Shahknovich
  • Bruce Carleton
  • J. Steven Leeder

External Institution(s)

  • Children's Mercy Hospitals and Clinics
  • University of British Columbia


Original languageEnglish (US)
Pages (from-to)140-150
Number of pages11
JournalClinical and translational science
Issue number2
StatusPublished - Mar 2019


Improving the utilization of pharmacologic agents in the pediatric population yields significant, perhaps life-long, benefits. Genetic factors related to the disposition of a medication or an alteration at the target receptor site contributes to the observed variability of exposure and response between individuals. An additional source of this variability specific to the pediatric population is ontogeny, where age-specific changes during development may require dose adjustments to obtain the same levels of drug exposure and response. With significant improvements in characterizing both the ontogeny and genetic contributions of drug metabolizing enzymes, the time is right to begin placing more emphasis on response rather than only the dose-exposure relationship. The amount of drug target receptors and the relative affinity for binding at that target site may require different levels of systemic exposure to achieve a desired response. Concentration-controlled studies can identify the needed exposure for a response at the drug target, the level of expression of the target site in an individual patient, and the tools required to individualize response. Although pediatrics represents a large spectrum of growth and development, developing tools to improve drug delivery for each individual patient across the spectrum of the ages treated by clinicians remains valuable.

Citation formats


McLaughlin, M. J., Wagner, J., Shahknovich, V., Carleton, B., & Leeder, J. S. (2019). Considerations for Implementing Precision Therapeutics for Children. Clinical and translational science, 12(2), 140-150.


McLaughlin, MJ, Wagner, J, Shahknovich, V, Carleton, B & Leeder, JS 2019, 'Considerations for Implementing Precision Therapeutics for Children', Clinical and translational science, vol. 12, no. 2, pp. 140-150.