COT-17 Cancer genomic medicine at Kobe University Hospital

Approximately one year has passed since the Japanese government approved a new plan to fight cancer by promoting the use of genomic medicine in June 2019. Our hospital plays an important role among 6 hospitals to serve cancer genomic medicine for cancer patients in Hyogo Prefecture. Here, we evaluated the system and the current status of cancer genomic medicine in our hospital, and examined future issues and problems. Consecutive 145 patients, who received outpatient treatment for cancer genomic medicine from July 2019 to June 2020 in Kobe University Hospital, were analyzed to examine patients’ background, implementation status, gene profile, and the number of subjects for treatment and clinical trials. The final result of gene profile was obtained in 93 cases, of which 49 cases (52.7%) showed the actionable gene changes to be treated. Six cases of brain tumor were 2 cases of glioblastoma, 2 cases of oligodendroglioma (recurrence), and 2 cases of AT/RT and CNS embryonal tumor. In one case the test was cancelled because Performance Status (PS) of the patient decreased. In another case the actionable gene mutation (PTEN, CDKN2A) was obtained, but the patient lived too far to visit clinical trial site. Almost half of genetic panel tests revealed genomic changes related to treatment, but the number of patients actually targeted for treatment or clinical trials was extremely small. It is necessary to consider the rapid progression of illness and access to facilities conducting clinical trials.