Establishment and implementation of Cancer Genomic Medicine in Japan

Abstract

Approximately 1 in 2 Japanese people are estimated to be diagnosed with cancer during their lifetime. Cancer still remains the leading cause of death in Japan, therefore the government of Japan has decided to develop a better cancer control policy and launched the Cancer Genomic Medicine (CGM) program. The Ministry of Health, Labour, and Welfare (MHLW) held a consortium at their headquarters with leading academic authorities and the representatives of related organizations to discuss ways to advance CGM in Japan. Based on the report of the consortium, the CGM system under the national health insurance system has gradually been realized. Eleven hospitals were designated in February 2018 as core hospitals for CGM; subsequently, the MHLW built the Center for Cancer Genomics and Advanced Therapeutics (C‐CAT) as an institution to aggregate and manage genomic and clinical information on cancer patients, and support appropriate secondary use of the aggregated information to develop research aimed at medical innovation. As the first step in Japan's CGM in routine practice, in June 2019 the MHLW started reimbursement of 2 types of tumor profiling tests for advanced solid cancer patients using the national insurance system. Japan's CGM has swiftly been spreading nationwide with the collaboration of 167 hospitals and patients. The health and research authorities are expected to embody personalized cancer medicine and promote CGM utilizing state‐of‐the‐art technologies.

Fighting Cancer around the World: A Framework for Action

“…High-income countries such as Australia offer universal health care and strongly funded research [ 57 ], high levels of public trust in health care governance and longstanding policies on personalized or precision medicine, leading to wide take-up of genomics, biomarkers, smart data generation and analytics, all bolstered by substantial national dialogue at the academic, industry and public levels. Japan, too, has established centralized databases (and reimbursement) for clinical and genomic tests, and outcome data that provide active feedback on treatment options [ 58 ], and the system is characterized by strong leadership and collaboration among academia, industry, government, and patients, with secure data transfer, strong links to hospitals, and good provision of education for health care workers, politicians, patients, and society, so personalized medicine in cancer is rapidly progressing. In Korea, national health insurance covers more than 70% of medical costs and provides NGS tests for cancer and rare genetic disorders [ 59 ].…”

Clinical application of comprehensive genomic profiling panel to thoracic malignancies: A single‐center retrospective study

“…The expert panel consisted of an oncologist for each organ, a clinical geneticist, a genetic counselor, a pathologist, a clinical trial coordinator, and a pharmacist. For detected alterations, oncogenicity was annotated based on the reports of each gene panel and Center for Cancer Genomics and Advanced Therapeutics (C-CAT) guidelines, 18 and treatment for oncogenic mutations was recommended based on the results of clinical trials mainly in Japan and the recommendation level (A to F) in C-CAT. 3,8 The possibility of drug treatment through the patient offer system was also proposed.…”

A State-of-the-Art Roadmap for Biomarker-Driven Drug Development in the Era of Personalized Therapies

“…Access—As databases such as disease registries are established in Japan [ 17 , 91 , 92 ], more biomarker, multi-omics data as well as electronic health data will accumulate. The content of these databases should be poised to be shared openly and efficiently, such that the curated data can be leveraged to its maximum.…”