内容紹介
Summary
In July 2018, olaparib, an oral poly adenosine diphosphate-ribose polymerase(PARP)inhibitor, was approved for the first time in Japan as a companion diagnostic drug for the treatment of recurrent breast cancer in BRCA-positive patients. Genetic testing had been offered only to clients who met the eligibility criteria for the test, and the decision whether or not to receive the test was based on their medical and family history, tumor characteristics, and the client's preference. With the approval of olaparib as a companion diagnostic drug, genetic testing has become a part of the standard treatment protocol. Modern technology has made multiple genetic testing possible in one setting. It is therefore necessary for medical practitioners to have the knowledge and ability to take care for familiar tumors. It may be difficult to understand all the available information on genetics, but an individualized approach for each patient would be necessary in the future. Medical practitioners involved in the treatment of such patients would need adequate knowledge on genetics and genetic counseling, as well as the ability to educate and provide information to the patients and their families. If a more specialized approach is necessary, referral to an institution with a clinical genetics department is essential.
要旨
2018年7月,乳癌領域では初めてコンパニオン診断薬として,BRCA遺伝子変異陽性の再発乳癌に対する経口ポリアデノシン5′二リン酸リボースポリメラーゼ(PARP)阻害剤が日本で承認された。これまでは既往歴や家族歴からそれぞれの遺伝性腫瘍に対するクライテリアを確認し,遺伝子検査を希望するクライアントのみが遺伝学的検査を行ってきたが,コンパニオン診断として日常診療に組み込まれ遺伝学は身近な存在となった。また,次世代シークエンサーにより一度に多数の遺伝子検索が可能になり,今までかかわることのなかった遺伝性腫瘍に対しても対応が迫られている。多数の遺伝子情報の解釈は困難を要するが,個々に応じた丁寧なサポートが必要になっていくであろう。治療にかかわる医師は,遺伝やカウンセリングについての知識をもち,患者説明への対応力が必須になった。さらに専門的な対応は,遺伝診療部をもつ施設との連携体制が大切である。
目次
In July 2018, olaparib, an oral poly adenosine diphosphate-ribose polymerase(PARP)inhibitor, was approved for the first time in Japan as a companion diagnostic drug for the treatment of recurrent breast cancer in BRCA-positive patients. Genetic testing had been offered only to clients who met the eligibility criteria for the test, and the decision whether or not to receive the test was based on their medical and family history, tumor characteristics, and the client's preference. With the approval of olaparib as a companion diagnostic drug, genetic testing has become a part of the standard treatment protocol. Modern technology has made multiple genetic testing possible in one setting. It is therefore necessary for medical practitioners to have the knowledge and ability to take care for familiar tumors. It may be difficult to understand all the available information on genetics, but an individualized approach for each patient would be necessary in the future. Medical practitioners involved in the treatment of such patients would need adequate knowledge on genetics and genetic counseling, as well as the ability to educate and provide information to the patients and their families. If a more specialized approach is necessary, referral to an institution with a clinical genetics department is essential.
要旨
2018年7月,乳癌領域では初めてコンパニオン診断薬として,BRCA遺伝子変異陽性の再発乳癌に対する経口ポリアデノシン5′二リン酸リボースポリメラーゼ(PARP)阻害剤が日本で承認された。これまでは既往歴や家族歴からそれぞれの遺伝性腫瘍に対するクライテリアを確認し,遺伝子検査を希望するクライアントのみが遺伝学的検査を行ってきたが,コンパニオン診断として日常診療に組み込まれ遺伝学は身近な存在となった。また,次世代シークエンサーにより一度に多数の遺伝子検索が可能になり,今までかかわることのなかった遺伝性腫瘍に対しても対応が迫られている。多数の遺伝子情報の解釈は困難を要するが,個々に応じた丁寧なサポートが必要になっていくであろう。治療にかかわる医師は,遺伝やカウンセリングについての知識をもち,患者説明への対応力が必須になった。さらに専門的な対応は,遺伝診療部をもつ施設との連携体制が大切である。