Activity on Nationwide Cancer Genome Screening Project for Metastatic Colorectal Cancer in Japan; SCRUM-Japan GI-SCREEN

Abstract

Abstract Several cancer genome alterations have been identified as important targets for mCRC treatment, which include BRAF mutation, HER-2 amplification/expression, microsatellite instability-high (MSI-H) and etc., for which corresponding agents showed promising activity in clinical trials. In addition, emerging concept in clinical development targeting microsatellite stable (MSS) mCRC comes into question which compound adding on an immune checkpoint inhibitor evokes immunity. Successful combination strategy evoking immunity will break out of the paradigm. Current clinical development of corresponding agents in molecularly characterized cohorts of cancer patients as well as in acquired targets by means of NGS- and blood-based molecular testing may represent more substantial progress toward precision medicine. We initiated the Nationwide Cancer Genome Screening Project in Japan (SCRUM-Japan GI-SCREEN) since 2015 to detect orphan-fractionated cancer subtypes. In addition, we also launched circulating tumor DNA (ctDNA) analysis-based cancer genome screening project since February 2018. On the basis of cancer genome alterations by NGS- and blood-based molecular testing, umbrella & basket-type investigator-initiated clinical trials with the National Patient Registry are anticipated to contribute to the establishment of the appropriate infrastructure in terms of the promotion of clinical development for orphan-fractionated cancer subtypes, which are regarded as having the low priority for pharmaceutical companies, but as having the high priority for cancer patients. Updates on activity in SCRUM-Japan GI-SCREEN will be presented.