It is hoped that the level and effectiveness of cancer treatment will be improved by determining the most appropriate cure for each patient.
Full-scale efforts will be made to promote cancer genome medicine, a method of treatment that analyzes the genes of each patient. A review commission at the Health, Labor and Welfare Ministry has selected 11 hospitals, including the National Cancer Center Hospital, as hubs for this objective.
Cancer occurs when a gene is damaged and then a mutation develops. A genetic mutation can take various forms, and the cancer affecting the same internal organ can vary from patient to patient. Conventional cancer treatment has not given due consideration to the forms of genetic mutations.
To grasp the type of mutation, the new method of treatment will analyze all genetic information, or genome, of a patient. Based on this, the method seeks to select the best one from among conventional cancer therapies.
Under the current circumstances, patients are not necessarily given appropriate treatment. Some patients can suffer severe side effects of anticancer drugs and their symptoms cannot be alleviated. There is a pressing need to improve the level of treatment.
Since 2015, the U.S. government has promoted cancer genome-based treatment. This movement is also spreading across Europe. One factor behind this is progress made in unraveling genetic mutations. The costs of genetic analysis have also been reduced.
In Japan, there have been clinical studies of genome medicine at some hospitals. However, this country has been behind in this respect because of such factors as the shortage of testing institutions.
Cut treatment costs
If the new method is put on a sound footing, it will reduce the kind of treatments that can unnecessarily inflict pain on patients. It will also curtail treatment costs, which are prone to rise for such reasons as that various methods of treatment are tried and drugs are also used to deal with side effects.
Attempts at genome-based treatment have identified the genes responsible for cancer in about 95 percent of patients, and obtained information about the possibility of treating about 70 percent of them.
In stages from April, genome-based treatment will be available at hub hospitals and at hospitals affiliated with them. The costs of necessary tests, such as hospitalization expenses, will likely be covered as part of "advanced medical treatment," a category of medical services to which insurance is applied.
The health ministry should foster specialists who can offer patients easy-to-understand explanations about test results.
The problem is that, even if the type of genetic mutation is identified, the possibility of the best option being discovered from among conventional methods is estimated at about 10 percent.
Efforts should be accelerated to develop a new method of treatment, thereby enabling as many patients as possible to receive the most appropriate cure. It is important to effectively utilize the information to be accumulated through full-scale efforts to promote genome-based treatment.
In the United States and European countries, a succession of therapeutic methods targeting specified genetic mutations have appeared. The problem of bloated medical expenses that accompanies the trend has been increasingly serious. In some instances, one-time treatment could cost more than 50 million yen in the United States.
Who will bear hefty expenses incurred, and how? In-depth discussions should be promoted in Japan, too, by looking steadily at progress in genome-based treatment.
(From The Yomiuri Shimbun,
Feb. 25, 2018)
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