Cancer genomic medicine started, but ... November 26, 15:31
"Dream custom medicine". This is called “Genomic Medicine”, a new treatment for cancer. Cancer has progressed, surgery is not possible, and anticancer drugs do not work. Finding the best treatment for such patients. In June, genetic testing was applied for the first time in Japan, and started full-fledged nationwide this fall. However, it has been pointed out from the field that “it will not reach the necessary patients as it is”. We will tell you about the issues of "genome cancer medicine".
What is cancer genomic medicine?
“Genome” refers to genetic information. Find out which gene caused the cancer and look for drugs that target the gene.
A 63-year-old man living in Tokyo was diagnosed with stage 4 prostate cancer four years ago. Metastasis to the lungs and lymph nodes, etc., which could not be removed by surgery, did not improve even after receiving anticancer drugs.
The genetic test that the man received with the thought of struggling. As a result, it turned out that the effect can be expected for the treatments approved for other types of cancer.
After administration, the cancer became smaller and improved to near-full cure.
The man says, “At first, the front of my eyes was completely dark, but life was saved by genomic medicine.”
I don't reach the patient I need
However, not everyone can receive this cancer genome medicine. The insurance coverage is limited to patients who are unable to expect the effects of “standard treatment” such as surgery, anticancer drugs, and radiation.
According to the Ministry of Health, Labor and Welfare, there is no evidence that it is still effective except for patients who have completed standard treatment.
Core hospital questionnaire
This time, NHK conducted a questionnaire survey at the “Core Hospital for Cancer Genomics”, which is the center of genomic medicine. Responses were received from 10 of 11 core hospitals nationwide.
“Patients who are refractory to standard treatment are the main subjects, and there is no merit of testing”
“If the test is not possible some time before the end of the standard treatment, the medical condition may worsen during the test, making it impossible to select a new treatment.”
Several hospitals have raised the scope of patients. Because the insurance coverage is limited to patients who have completed standard treatment, even if genome testing is performed, it may be too late.
A woman in her 50s who suffered from pancreatic cancer was genetically tested at her own expense, as it was late after the cancer had progressed.
The cost was over 600,000 yen. It became a big burden. The woman says, “I think it's honest nonsense that you can't use insurance until the final stage.”
In addition, some other issues were presented in the questionnaire.
“The biggest problem is that even if a genetic mutation is found, it is not possible to reach the corresponding drug.”
“There are few people who can lead to treatment”
In other words, there are many people who are not connected with treatment even if genome testing is performed.
Even if the gene of the cause is known, it cannot be linked to treatment unless a corresponding drug has been developed. Even if an effective drug is found, if it is not approved in Japan, medical insurance may not be applied and the cost of treatment may be high.
Of those who have been tested, only 10% to 20% have reached effective drug administration.
“There are not enough specialists to analyze the genome”
"Expansion of development program is not discussed"
This is a problem that the system for genome testing is not enough. It was also pointed out that the current method puts a heavy burden on the core base hospital.
Genome medical insurance coverage is just beginning. It is expected that the expansion of the target will be considered from now on, but it is unknown how far it will spread within the limited medical expenses.
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