Nishida Toshirou
Dept. of Gastric Surgery, National Cancer Center Hospital.
Gan To Kagaku Ryoho. 2018 Sep;45(9):1223-1227.
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.
在政府倡议下，已实施了在现实世界中提供癌症基因组医学的框架。2018年4月，指定了11家癌症基因组医学指定核心医院和100家癌症基因组医学合作医院。在合作医院中，经希望接受癌症基因组医学治疗的癌症患者知情同意后，可将标本提交进行基因检测。基因检测完成后，主治医生应参加在指定核心医院举行的专家小组会议，以决定推荐的治疗方案，这可在患者同意的情况下进行。此外，指定核心医院还需进行多基因检测（可外包），定期举行专家小组会议以根据注释信息决定推荐的治疗方案，主要开展研究者发起的临床试验和高级医疗B，培养癌症基因组医学方面的专业人才，并在必要时为合作医院开展癌症基因组医学提供临床支持。基因组和临床信息可从这些医院和机构集中到癌症基因组学与先进治疗中心（C-CAT），以开发日本癌症患者的新知识数据库，并在未来开发全新药物。
