演題抄録

臓器別シンポジウム

開催概要
開催回
第58回・2020年・京都
 

消化器がんにおけるがんゲノム医療の現状と展望~内科医の立場から~

演題番号 : SY1-2

[筆頭演者]
谷口 浩也:1 

1:国立がん研究センター東病院・消化管内科

 

In recent years, understanding of tumor biology and the molecular features of gastrointestinal (GI) cancer have been improved mainly thanks to remarkable advances in next-generation sequencing technologies. In fact, distinct molecular subtypes have been identified which could serve as a roadmap for patient stratification and trials of targeted therapies. To accelerate innovation in precision oncology, we initiated a nationwide GI cancer genome screening project, GI-SCREEN, within the SCRUM-Japan network with the specific purpose of matching a national-scale GI cancer population with a diverse portfolio of affiliated interventional targeted therapy trials in 2015. In GI-SCREEN, advanced GI cancer patients presenting to network institutions for clinical care are screened using a comprehensive tissue DNA sequencing panel before or during systemic therapy. On progression after standard therapy, these prescreened patients are then enrolled in an applicable matched clinical trial. Moreover, we initiated GOZILA-a screening study based on the GI-SCREEN platform but that rather utilizes comprehensive circulating tumor DNA (ctDNA) sequencing to rapidly screen patients for trial eligibility in 2018. Comparing the utility of ctDNA sequencing in the screening of 1,687 patients with advanced GI cancer in SCRUM-Japan GOZILA to the utility of tumor tissue sequencing in GI-SCREEN with 5,621 patients, ctDNA genotyping significantly shortened the screening duration (by 22 days) and improved the trial enrollment rate (by 5.4%) compared to tissue genotyping (Nakamura Y, Taniguchi H, et al. NatMed 2020). MONSTAR-SCREEN is also one of our genome screening platforms to monitor clinical course and to reveal landscapes of resistant mechanisms of molecular-targeted therapy started by 2019. In the future perspectives, whole exon and whole genome analyses will be also utilized for precision medicine.

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