Does Precision Medicine become patient's saviour?

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K18439
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Review Section: A New Phase of Our Advanced Science and Technology Society
• Research Institution: Juntendo University
• Principal Investigator: Sakurai Shinobu 順天堂大学, 医療看護学部, 教授 (60225844)
• Co-Investigator(Kenkyū-buntansha): 白石 泰三 三重大学, 医学系研究科, リサーチアソシエイト (30162762) ; 南 唯公 (中西唯公) 順天堂大学, スポーツ健康科学部, 准教授 (50582110)
• Project Period (FY): 2018-06-29 – 2022-03-31
• Keywords: プレシジョンメディスン / がんゲノム医療 / 遺伝子パネル検査 / インタビュー調査 / 遺伝カウンセリング / がん患者QOL

Outline of Final Research Achievements

The purpose of this study was to identify problems in the current state of precision medicine, to explore related factors and propose a way forward for cancer genome medicine. The study subjects were 30 medical professionals from all over Japan who were interviewed. In the U.S., the survey was conducted at a cancer genome medicine hospital and a general clinic to understand the basic flow of standardized cancer treatment in the U.S. Many challenges to insurance coverage of genomic medicine, so called "expert-panel" were identified in terms of medical costs and the system itself, and confusion was observed in the hospital. Only about 10 percent of patients actually can access the drug as a clinical trial and treatment, and the original effectiveness of the system is not yet clear. It was pointed out that it is important issues to maintain the patient's quality of life and to link this with terminal care.

Free Research Field

公衆衛生看護学

Academic Significance and Societal Importance of the Research Achievements

「がん」は我が国の死因のトップで国民の2人に1人が罹患する。そこでプレシジョンメディスンとして、がんゲノム医療の実現のために、第一段階としてエキスパートパネルを令和元年6月に保険適用とした。しかし、エキスパートパネルを経て治療につながるのは1割程度であり、生存期間の延長効果も不明である。標準治療が無くゲノム医療に頼った患者には利益が薄く、医療側もゲノム医療の理解不足、対応する物理的時間の欠如、コメディカルの絶対的不足が影響していた。治療対象外となった９０％の患者の気持ちに寄り添い今後の療養に向き合えるような、がんゲノム医療とターミナルケアやQOL維持を同時に行うシステム創りが急務である。