Research and innovation in personalized medicine (PM) are extensive and expanding, with several pharmacogenetic/pharmacogenomic (PGx) testing options currently available for a wide range of health problems. However, PGx-guided therapy faces many barriers to full integration into clinical practice and acceptance by practitioner/patient: utilization and uptake by payers in real-world practice are being discussed, and the criteria to guide clinicians and policy makers in PGx test selection are not fully incorporated. This review focuses on the advances of pharmacogenomics to individualize treatments, the relationship between pharmacogenetics and pharmacometabolomics, the new paradigm of the Big Data, the needs and barriers facing PGx clinical application and the situation of PGx testing in health national services. It is based on lectures presented by speakers of the European Society of Pharmacogenomics and Personalised Therapy (ESPT) Fourth Conference, held in Catania, October 4th, 2017.
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