This is a new submission for the Translational Scholar Career Awards in Pharmacogenomics and Personalized medicine (K23) for Andrew A. Monte, MD. Dr. Monte's overall career goal is to become a leading independent researcher in personalized medicine. His innovative research proposal integrates clinical, genomic, cytochrome metabolism phenotype, and metabolomic factors to develop a model that predicts systolic blood pressure decline due to metoprolol. Candidate: Dr. Monte is a board-certified Emergency Medicine &Medical Toxicology physician, Assistant Professor of Emergency Medicine &Medical Toxicology at the University of Colorado Denver (UCD) School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences. Training: The proposed career development plan augments Dr. Monte's prior training and experience to focus on specific, advanced training in: (1) pharmacogenomics methods;(2) pharmacokinetic analyses;(3) metabolomic analyses;and (4) predictive model building. Dr. Monte proposes to acquire these skills through intensive focused mentorship, relevant advanced coursework, and guided research. These training activities will help Dr. Monte gain the necessary skills to become a leader in personalized medicine. Mentors/Environment: Dr. Monte has established a close working relationship with his primary mentor, Dr. Vasilis Vasiliou, a leading researcher in genomics with a long track record of mentoring. His co-mentor, Dr. Richard M. Weinshilboum, is a national expert and researcher on drug metabolizing enzymes. In addition, an advisory panel of experts in pharmacokinetics, metabolomics, model building, and research career development will monitor Dr. Monte's progress and providing additional topical guidance. The Department of Emergency Medicine is committed to supporting Dr. Monte's growth into an independent researcher, including a commitment of protected time and resources for this career development award. In addition, UCD provides Dr. Monte with a rich research environment, including access to resources and collaborators at the CCTSI. Research: Dr. Monte's research proposal gathers clinical, genomic (Aim 1), cytochrome (CYP) metabolism phenotype (Aim 2), and metabolomic data (Aim 3) in a prospective trial of a patients beginning metoprolol therapy for uncontrolled hypertension. These factors will be compared to identify which variables predict the drug response to metoprolol. These data will be integrated into a model to predict systolic blood pressure reduction due to metoprolol. Summary: This innovative approach integrates clinical, genomic, CYP metabolism phenotype, and metabolomic data to predict the drug response of metoprolol. The integrative approach can be applied to other diseases and therapeutics to improve drug efficacy and safety. The training plan and research proposal will help Dr. Monte develop into an internationally-recognized independent investigator in personalized medicine.

Public Health Relevance

There has been an explosion on pharmacogenomic, pharmacokinetic, and clinical data associated with the efficacy of prescribed drugs. Unfortunately, this data has not resulted in widespread success of personalized medicine;defined as the right drug, at the right dose, in the right patient. An approach that integrates and accounts for all of these factors together is more likely to efficiently predict the clinical drug effect. This integrated approach could be applied to numerous drugs increasing the efficacy and safety of prescriptions. Metoprolol is a drug used to treat hypertension and represents the first drug with enough pharmacogenomic, pharmacokinetic, and clinical data to build an integrated model. The overarching objective of this career development award is to support the development of Dr. Andrew Monte, MD, into a leader in personalized medicine. He aims to coordinate a clinical trial that captures genomic, pharmacokinetic, metabolomic, and efficacy data to build and integrated model that predicts metoprolol efficacy for the treatment of hypertension.

National Institute of Health (NIH)
National Institute of General Medical Sciences (NIGMS)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
Xenobiotic and Nutrient Disposition and Action Study Section (XNDA)
Program Officer
Okita, Richard T
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Colorado Denver
Emergency Medicine
Schools of Medicine
United States
Zip Code
Saben, Jessica L; Shelton, Shelby K; Hopkinson, Andrew J et al. (2018) The Emergency Medicine Specimen Bank: An Innovative Approach To Biobanking In Acute Care. Acad Emerg Med :
Hall, Katelyn E; Monte, Andrew A; Chang, Tae et al. (2018) Mental Health-related Emergency Department Visits Associated With Cannabis in Colorado. Acad Emerg Med 25:526-537
Monte, Andrew A; Libby, Anne M (2018) Introduction to the Specific Aims Page of a Grant Proposal. Acad Emerg Med 25:1042-1047
Fox, Jacob; Smith, Alexis; Yale, Alexander et al. (2018) Drugs of Abuse and Novel Psychoactive Substances at Outdoor Music Festivals in Colorado. Subst Use Misuse 53:1203-1211
Monte, Andrew A; West, Kelsey; McDaniel, Kyle T et al. (2018) CYP2D6 Genotype Phenotype Discordance Due to Drug-Drug Interaction. Clin Pharmacol Ther 104:933-939
Brandehoff, Nicklaus; Adams, Axel; McDaniel, Kyle et al. (2018) Synthetic cannabinoid ""Black Mamba"" infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort. Clin Toxicol (Phila) 56:193-198
Monte, Andrew A; Sun, Hao; Rapp-Olsson, Anna Malin et al. (2018) The Plasma Concentration of MUC5B Is Associated with Clinical Outcomes in Paraquat-poisoned Patients. Am J Respir Crit Care Med 197:663-665
Sorensen, Cecilia J; DeSanto, Kristen; Borgelt, Laura et al. (2017) Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. J Med Toxicol 13:71-87
Sorensen, Cecilia J; DeSanto, Kristen; Borgelt, Laura et al. (2017) In Response to Letter to the Editor Regarding: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. J Med Toxicol 13:198
Flaten, Hania K; Monte, Andrew A (2017) The Pharmacogenomic and Metabolomic Predictors of ACE Inhibitor and Angiotensin II Receptor Blocker Effectiveness and Safety. Cardiovasc Drugs Ther 31:471-482

Showing the most recent 10 out of 28 publications