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日本对新一代测序和互补诊断的监管视角。

Regulatory perspectives on next-generation sequencing and complementary diagnostics in Japan.

机构信息

Department of Clinical Pharmacology, Tokai University School of Medicine , Isehara, Japan.

Department of Medical Informatics, Kagawa University Hospital , Takamatsu, Japan.

出版信息

Expert Rev Mol Diagn. 2020 Jun;20(6):601-610. doi: 10.1080/14737159.2020.1728256. Epub 2020 Feb 17.

Abstract

INTRODUCTION

The 'one biomarker/one drug' scenario is unsustainable because cancer is a complex disorder that involves a number of molecular defects. In the past decade, major technological advances have lowered the overall cost and increased the efficiency of next-generation sequencing (NGS).

AREAS COVERED

We review recent regulations on NGS and complementary diagnostics in Japan, mainly focusing on high-quality studies that utilized these new diagnostic modalities and were published within the last 5 years. We highlight significant changes in regulation, and explain the direction of efforts to translate the results of NGS and complementary diagnostics into clinical practice.

EXPERT OPINION

NGS holds a number of advantages over conventional companion and complementary diagnostics that enable simultaneous analyzes of multiple cancer genes to detect actionable mutations. Parallel technological developments and regulatory changes have led to the rapid adoption of NGS into clinical practice. NGS-based genomic data have been leveraged to better understand the characteristics of a disease that affects its patient's response to a given therapy. As NGS-based tests become more widespread, however, Japanese authorities will face significant challenges particularly with respect to the complexity of genomic data, which will have to be managed if NGS is to benefit patients.

摘要

简介

“一个生物标志物对应一种药物”的模式是不可持续的,因为癌症是一种复杂的疾病,涉及许多分子缺陷。在过去的十年中,重大技术进步降低了下一代测序(NGS)的整体成本并提高了其效率。

涵盖领域

我们综述了日本 NGS 和配套诊断检测的最新法规,主要侧重于在过去 5 年内利用这些新诊断模式发表的高质量研究。我们强调了监管方面的重大变化,并解释了将 NGS 和配套诊断检测结果转化为临床实践的努力方向。

专家意见

NGS 相对于传统伴随诊断和补充诊断具有许多优势,能够同时分析多个癌症基因以检测可操作的突变。平行的技术发展和监管变革推动了 NGS 在临床实践中的快速采用。基于 NGS 的基因组数据已被用于更好地了解影响患者对特定治疗反应的疾病特征。然而,随着基于 NGS 的检测变得更加广泛,日本当局将面临重大挑战,特别是在基因组数据的复杂性方面,如果要使 NGS 使患者受益,就必须对其进行管理。

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