United States clinical practice guidelines for metastatic colorectal cancer recommend use of medications impacted by genetic variants but do not recommend testing. We analyzed real-world treatment using a cancer registry and claims dataset to explore pharmacogenomic (PGx) medication treatment patterns and characterize exposure. In a cohort of 6957 patients, most (86.9%) were exposed to at least one chemotherapy medication with PGx guidelines. In a cohort of 2223 patients with retail pharmacy claims available, most (79.2%) were treated with at least one non-chemotherapy (79.2%) medication with PGx guidelines. PGx-associated chemotherapy exposure was associated with age, race/ethnicity, educational attainment, and rurality. PGx-associated non-chemotherapy exposure was associated with medication use and comorbidities. The potential impact of PGx testing is large and policies aimed at increasing PGx testing at diagnosis may impact treatment decisions for patients with metastatic colorectal cancer as most patients are exposed to medications with pharmacogenomics implications during treatment.

美国转移性结直肠癌临床实践指南建议使用受遗传变异影响的药物，但不建议进行检测。我们使用癌症登记和索赔数据集分析了现实世界的治疗，以探索药物基因组 (PGx) 药物治疗模式并表征暴露。在 6957 名患者的队列中，大多数 (86.9%) 根据 PGx 指南暴露于至少一种化疗药物。在有零售药店索赔的 2223 名患者队列中，大多数 (79.2%) 接受了 PGx 指南中至少一种非化疗药物 (79.2%) 的治疗。PGx 相关的化疗暴露与年龄、种族/民族、教育程度和农村有关。PGx 相关的非化疗暴露与药物使用和合并症有关。