Cited by 712Genetic Associations and EpidemiologyComputational Drug Discovery MethodsGenomics and Rare Diseases

Validating therapeutic targets through human genetics

Plenge, Robert M., Scolnick, Edward M., Altshuler, David·2013·Nature Reviews Drug Discovery

Abstract

More than 90% of the compounds that enter clinical trials fail to demonstrate sufficient safety and efficacy to gain regulatory approval. Most of this failure is due to the limited predictive value of preclinical models of disease, and our continued ignorance regarding the consequences of perturbing specific targets over long periods of time in humans. 'Experiments of nature' - naturally occurring mutations in humans that affect the activity of a particular protein target or targets - can be used to estimate the probable efficacy and toxicity of a drug targeting such proteins, as well as to establish causal rather than reactive relationships between targets and outcomes. Here, we describe the concept of dose-response curves derived from experiments of nature, with an emphasis on human genetics as a valuable tool to prioritize molecular targets in drug development. We discuss empirical examples of drug-gene pairs that support the role of human genetics in testing therapeutic hypotheses at the stage of target validation, provide objective criteria to prioritize genetic findings for future drug discovery efforts and highlight the limitations of a target validation approach that is anchored in human genetics.

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Crossref · 10.1038/nrd4051

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  • Individual clinical tests, biomarkers, and prescription drug efficacy may vary across populations in their utility, but are fundamentally informed by the same underlying biology.

    “Individual clinical tests, biomarkers, and prescription drug efficacy may vary across populations in their utility, but are fundamentally informed by the same underlying biology64,65.”
  • Identifying allelic series can help prioritize candidate drug targets.

    “Identifying allelic series, in which multiple variants in a gene associate with a phenotype with varying effect sizes, can help prioritize candidate drug targets13,14.”
  • This enables more rigorous evaluation of the contribution of rare and common variants to trait susceptibility and supports enumeration of allelic series critical for studies of disease mechanism and therapeutic target optimization.

    “This enables more rigorous evaluation of the contribution of rare and common variants to trait susceptibility48 and supports the enumeration of ‘allelic series’ (sets of alleles of varying frequency, effect size and direction that disrupt the same gene) critical for studies of disease mechanism and therapeutic target optimization89,96.”

    From A brief history of human disease genetics (2020) · cites this paper as [89]

  • These findings inform prioritization of therapeutic targets, providing clues to potential on-target side effects and opportunities for drug repurposing.

    “These findings inform the prioritization of therapeutic targets, providing clues to potential on-target side effects and opportunities for drug repurposing87–89.”

    From A brief history of human disease genetics (2020) · cites this paper as [89]

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Authors
Plenge, R. M., Scolnick, E. M., & Altshuler, D.
Affiliations
  • Brigham and Women's Hospital (US)
  • Broad Institute (US)
Corresponding author
Plenge, Robert M.
Venue
Nature Reviews Drug Discovery
Published
2013-07-19
Volume
12
Issue
8
Pages
581-594
ISSN
  • 1474-1776 (ISSN-L)
  • 1474-1784
OpenAlex
W2143282831
Cited by
712
References
114
Citations by year
2026: 44 · 2025: 61 · 2024: 88 · 2023: 39 · 2022: 42 · 2021: 48 · 2020: 53 · 2019: 64 · 2018: 51 · 2017: 57 · 2016: 59 · 2015: 55 · 2014: 44 · 2013: 7
FWCI
6.75
Type
journal article
Language
en
Open access
closed
Locations
  • Nature Reviews Drug Discovery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Physical Sciences › Computer Science › Computational Theory and Mathematics › Computational Drug Discovery Methods
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
Keywords
target validation, human genetics, natural mutation, drug development, clinical trial failure, preclinical models, dose-response curves, drug target prioritization, causal inference
MeSH terms
Clinical Trials as Topic, Genetics, Medical, Humans, Models, Biological, Pharmacogenetics, Biomarkers, Drugs, Investigational, Treatment Failure, Drug Discovery, Early Termination of Clinical Trials, Molecular Targeted Therapy

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