t would be the ultimate in personal service: medical treatment tailored to match exactly your personal genetic makeup. Understanding how your body is likely to react to certain thera-pies would potentially eliminate side effects and increase the efficacy of the drugs you take. That, loosely, is the promise of pharmacogenomics—but until recently it seemed a very distant goal.Events last autumn have changed all that. When a group of painkillers known as COX-2 inhibitors, used to treat arthritis, were linked to an increased risk of heart disease, the idea of personalized medicine gained some very public momentum (see Box 1 ). The idea that targeting drugs to individuals can save lives has helped to boost the role of pharmacogenomics.In March, the US Food and Drug Administration (FDA) released guidelines that encourage, but do not require, companies to provide pharmacogenomic data in new appli-cations for drug approval. This information would predict how a patient might respond to a drug based on their genetic profile: both the gene variants they have inherited and the expression pattern of those genes. This small regulatory step will translate into jobs all along the drug discovery and development pipeline. Those who can acquire the right mix of skills now will be poised to take advantage of what some see as a complete restructuring of the pharmaceutical industry.“The FDA guidance document has opened up a large opportunity for people with pharma-cogenomics knowledge to help pharmaceutical companies navigate the path forwards,” says Michael Murphy, president and chief execu-tive of Gentris, a pharmacogenomics company in Morrisville, North Carolina. Gentris has already opened a consulting division to meet the growing demand for expertise in combin-ing genomics knowledge with statistics, bioin-formatics and quality assurance.In the past five years, every large pharma-ceutical company has set up a pharmacoge-nomics group, says John Ryan, senior vice president of translational medicine at Wyeth Pharmaceuticals in Collegeville, Pennsylvania. “Based on the technology, the resurgence of biotech, and the fact that the drug industry is being pressed to do things differently, there will be hundreds of openings in pharmacogenom-ics over the next several years,” he predicts.Wolfgang Sadee, director of the pharma-cogenomics program at Ohio State University in Columbus, adds that it will be five years until drug companies fully embrace the field. “If we train people now,” he says, “in five years they will be in the right position to help out.”The earlier approach of pharmacogenetics, which targets a single gene, has already scored some successes. Herceptin (trastuzumab), for example, treats breast cancer by targeting a single receptor on tumor cells that is over-abundant in women who inherit a specific gene mutation. And the analysis of individual genes that affect drug metabolism has helped to improve efficacy.With its emphasis on multiple genes and their expression patterns, pharmacogenom-ics extends the reach of its predecessor. For instance, researchers at the University of Toronto in Canada have identified 18 genes whose expression pattern predicts whether or not a person will respond to treatment for hep-atitis C. Current treatment (interferon plus rib-avirin) works for only half of them. Measuring expression of these genes could indicate who can be helped, right from the start.