Current status and issues of cancer genomic medicine in regional city

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  • 地方におけるがんゲノム医療の現状と課題～地方がんゲノム医療連携病院での経験～

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Abstract

<p>　In accordance with the Ministry of Health, Labour and Welfare's basic plan for promotion of cancer control, almost all prefectures are establishing a system that enables the provision of cancer genomic medicine under insurance coverage, but in reality there are regional disparities due to various factors. Cancer Genome Medicine Cooperation Hospitals in rural areas continue to provide cancer genome medicine while struggling with issues such as a shortage of human resources, difficulty in accessing clinical trials，and a lack of understanding of cancer genome medicine．Since April 2019, our hospital has been certified as cancer genome medicine cooperation hospital and has conducted comprehensive genome profiling（CGP）tests in 44 cases. Of these, only 4 patients received genomically-matched therapies, and the proportion of matched therapies was 9%. Except for one pancreas cancer patient with BRCA1 germline variant, no patients arrived the matched therapy among common cancer such as colon or lung. The reason of low proportion of matched therapy is mostly due to the small number of actionable variant, but also include the difficulty of access to clinical trials, lack of awareness of cancer genomic medicine in the community, and lack of interest among medical staff. Although there is no immediate effective solution to these issues, it is necessary to continue accumulating each cases and improving in-house provision system.</p>

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