Health and Global Policy Institute (HGPI)/NCD Alliance Japan held the first advisory board meeting of the “Project for Considering the Future of Precision Medicine with Industry, Government, Academia, and Civil Society.” To prevent the potential spread of Coronavirus Disease 2019 (COVID-19), the meeting was held entirely online and was closed to the public.

Since the Cancer Control Act was enacted in 2007, Japan has implemented comprehensive cancer control measures based on five-year plans called Basic Plans to Promote Cancer Control Programs. Under the current program, the third-term Basic Plan to Promote Cancer Control Programs (2018-2022), steps are being taken to “promote precision medicine using cancer genome analysis technologies,” a field which has seen remarkable progress in recent years. These initiatives are to serve as a pillar for field-centric measures aiming to “improve cancer treatment.” Widespread availability of diagnoses and treatments based on cancer genome information is likely to enable the provision of preferential treatments that are optimized for the individual, reducing physical and mental burdens on patients.

However, there are issues that must be addressed in every aspect of precision medicine. For example, tests used to examine abnormalities across multiple genes related to cancer development called cancer gene panels are generally only available to patients who have completed standard treatments currently granted coverage in the insurance system. This means some patients see their conditions worsen between testing and treatment, while others are unable to find the pharmaceutical that best suits them. As a result, only 10% to 20% of patients are able to persevere until the optimal treatment is found. In the future, various issues that must be resolved include determining the timing and number of these tests, achieving equity in the cancer genome therapy provision system through which this testing is provided, and balancing testing with public finances.

In response, HGPI/NCD Alliance Japan launched this project to stimulate collaborative discussions with domestic and international stakeholders and to formulate effective policy recommendations. At the first advisory board meeting, we gathered opinion leaders and related parties in this field representing industry, Government, academia, and civil society to hold a discussion that focused mainly on the four points listed below.

1. Improving access to precision medicine (namely, testing and treatment)
2. Striking a sustainable balance with public finance
3. Further promoting research and development
4. Ethical, Legal and Social Issues (ELSIs) and other issues surrounding the above three items.

■ Event overview
Date and time: Tuesday, December 14, 2021; from 13:00 to 15:00
Venue: Online using the Zoom conferencing system
Host: Health and Global Policy Institute (HGPI)

■ First Advisory Board Meeting participants (Titles omitted; in no particular order)
Ataru Igarashi (Associate Professor, Unit of Public health and Preventive Medicine, Yokohama City University School of Medicine)
Mitsuho Imai (Project Assistant Professor, Shinanomachi Cancer Center, School of Medicine, Keio University)
Hiroji Iwata (Vice Director and Chief, Department of Breast Oncology, Aichi Cancer Center Hospital)
Atsushi Otsu (Director, National Cancer Center Hospital East)
Shinji Kosugi (Professor, Medical Ethics and Medical Genetics, Department of Social Medicine, Graduate School of Medicine and Faculty of Medicine, Kyoto University)
Naomi Sakurai (President, Cancer Solutions Co., Ltd)
Kuniko Sunami (Department of Laboratory Medicine, National Cancer Center Hospital)
Yusuke Tsugawa (Associate Professor, David Geffen School of Medicine (Internal Medicine), University of California, Los Angeles (UCLA); Associate Professor, Health Policy and Management; Faculty Associate, UCLA Center For Health Policy)
Kazuo Hasegawa (Representative, NPO Lung Cancer Patient Association One Step)
Yoshiyuki Majima (Chairman, NPO PanCAN Japan)
Tetsuya Mitsutomi (Professor/Senior Staff, Division of Thoracic Surgery, School of Medicine, Kindai University)
Takayuki Yoshino (Director, Department of Gastrointestinal Oncology, National Cancer Center Hospital East)
Reiko Akizuki (Director, Oncology Department, Medical Affairs Division, Janssen Pharmaceutical K.K.)
Kosuke Iijima (Head, Foundation Medicine Business Department, Chugai Pharmaceutical Co., Ltd.)
Sotaro Enatsu (General Manager, Oncology Business Unit, Research and Development and Medical Affairs, Eli Lilly Japan K.K.)