[The Roles of Designated Core Hospitals and Cooperative Hospitals for Cancer Genomic Medicine in Japan].

The frameworks providing cancer genome medicine in the real world have been implemented under the government initiatives. In April 2018, 11 Designated Core Hospitals for Cancer Genomic Medicine and 100 Cooperative Hospitals for Cancer Genomic Medicine were designated. In the Cooperative Hospitals, the specimens may be submitted to the genetic testing after informed consent from cancer patients who wishes to have cancer genome medicine. On completion of the genetic testing, attending physicians should participate in the expert panel held at the Designated Core Hospitals to decide the recommended treatment, which may be done under patients' consent. The Designated Core Hospitals, in addition, are required to conduct multiple-gene panel testing(outsourcing is acceptable), to hold the regular expert panel to decide the recommended treatment based on annotation information, to mainly conduct investigator-initiated clinical trial and advanced medical care B, to nurture specialized human resources involved in cancer genome medicine, and to provide clinical support for the Cooperative Hospitals to conduct cancer genome medicine when necessary. Genomic and clinical information may be centralized from these hospitals and institutes to the Center for Cancer genomics and Advanced Therapeutics(C-CAT)to develop new knowledge databases of Japanese cancer patients as well as to develop brand new medicines in future.