The First Part: Promoting Social Implementation of Genome Medicine with Information Technology, Xcoo

Utilizing Genome Analysis and Bioinformatics in Medical Care

In recent years, there has been tremendous development in cancer genome medicine.
Cancer genome medicine is the study of the genome of cancer cells to learn which genes are being altered and to select the nature of each patient's cancer and what treatment is appropriate for them [1]. As I practice lung cancer treatment, I constantly struggle to update genomic medical information.
Drug therapy for cancer has been centered on the use of chemotherapeutic agents (anticancer drugs). In the 2000s, however, drugs targeting specific gene abnormalities (molecularly targeted drugs) came into use. In the 2010s, tests to determine the efficacy of specific molecular targeted drugs in advance (companion diagnostics) were introduced, enabling more effective use of molecularly targeted drugs. Further advances in testing technology have led to the development of cancer gene panel tests, which will be available in Japan on an insured basis from June 2019, entering the full-fledged practical stage of cancer genome medicine [1].

The cancer gene panel test, which is spreading nationwide, examines the genetic changes in cancer cells to determine the characteristics of cancer. If the characteristics of the cancer are known, there is a possibility of finding the appropriate treatment (e.g., molecular-targeted drugs) for each individual patient [2]. From the patient's cancer tissue or blood, dozens to hundreds of genes in the cancer cells are examined to identify their genetic changes. Depending on the genetic changes, it may be possible to determine which drugs are more likely to work. The test results are reviewed by a group of experts called an “expert panel.” The doctor in charge will recommend a treatment to the patient based on the results discussed by the expert panel.

This type of cancer gene panel test, covered by insurance, is not available at any medical facility but only at medical institutions designated by the Ministry of Health, Labor and Welfare in Japan. Currently, 233 hospitals^*1 have been set nationwide [3].

Xcoo, Inc. (referred to below as “Xcoo”) is a start-up company that aims to contribute to the social implementation of genome medicine using information technology, with genome medicine as its main business domain. Xcoo uses “Chrovis,” a total solution software for genome and bioinformatic analysis developed by the company, to analyze genome information for cancer diagnosis, treatment, and prevention, as well as for cutting-edge research and development.

Xcoo also focuses on “annotation,” which adds helpful information to the analysis results for decision-making in clinical settings. Cancer gene panel test is a revolutionary method. However, a major challenge is the time-consuming process of interpreting the analysis results and preparing reports. We utilize information technology to automatically process huge amounts of data across multiple databases to support the work of physicians in judging test results and provide information to patients.

As a physician, it is very reassuring to know that the service efficiently provides correct information in terms of interpreting the results of the analysis described above in cancer treatment, which is advancing day by day. In addition, it is a beneficial service because it helps to reduce the workload on busy days.

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