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J.Jpn. Surg. Soc.. 122(3): 330-334, 2021


Feature topic

CURRENT STATUS AND CHALLENGES OF CANCER PRECISION MEDICINE

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

Tetsu Hayashida, Shigeo Yamaguchi, Yuko Kitagawa

The development of next-generation sequencer (NGS) technology has presented a new option for cancer precision medicine. The utilization of NGS technology in clinical practice is progressing. As a result of technical and policy attempts by many experts, this new form of medical treatment has been provided to the public as an insured treatment in Japan. However, a number of problems have been pointed out. The technical problems include the fact that the interpretation of the results is divided due to differences in algorithms and discrepancies between databases, and that each gene panel has different characteristics. Many other issues need to be resolved, such as the medical indications, timing, and need for repeated gene panel testing. The introduction of gene panel tests is progressing in breast cancer treatment, and the number of tests conducted is increasing, but various problems have also emerged. In particular, there is still no consensus on when gene panel testing should be performed in breast cancer treatment and what outcomes should be used to establish medical evidence. In the future, the introduction of gene panel testing using liquid biopsy should be considered and applied clinically based on an appropriate understanding.


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