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As of December 2023, there are 5 types of cancer gene panel tests covered by public insurance in Japan. Four of them partly feature companion diagnostics. When cancer gene panel test is used for the purpose of comprehensive gene profiling (CGP), a total of 56,000 points(44,000 points for the test administration fee and 12,000 points for the expert panel fee) can be claimed, whereas if the cancer gene panel test is used for the purpose of companion diagnostics, hospitals can claim only the reimbursement as a companion diagnostics, which fee is much cheaper than that of CGP. Therefore, cancer gene panel tests are rarely used as a companion diagnosis in daily clinical practice. Even when the test is performed as a CGP test, since its indication is limited to patients who have completed or are expected to complete standard chemotherapy, most biomarkers associated with approved drugs are already evaluated with stand-alone companion diagnostics at the time of CGP test application. On the other hand, there are some approved drugs, such as pembrolizumab for TMB-H or entrectinib or larotrectinib for NTRK fusion gene, for which there is no stand-alone companion diagnostics and the eligibility for these drugs cannot be judged without the results of CGP test. This paper discusses the current status and issues of companion diagnostics in cancer genomic medicine.

The Common Terminology Criteria for Adverse Events has been used to evaluate adverse events in oncology. However, it has been shown that medical practitioners who assess adverse events tend to underestimate symptoms more than the patients themselves who experience them, and monitoring of patient-reported outcomes(PROs)is considered essential to achieve patient-centered care. PRO is defined as"any report of a patient's health status obtained directly from the patient, without interpretation by a clinician or anyone else". PROs have been routinely collected in clinical practice using paper and pencil, but they can also be collected more easily and efficiently in the form of electronic PROs(ePROs)using tablets and smartphones. The ePRO system enables remote symptom monitoring and intervention, when necessary, as PROs entered by the patient are shared with the health care provider even when not in person, which not only improves the patient's quality of life but also has been reported to increase overall survival. In Japan, ePROs that can be used in routine medical care are already available, but they have not yet been widely adopted. This article outlines the necessity and usefulness of ePRO monitoring in the treatment of cancer patients, problems and solutions for its introduction and dissemination, and prospects in daily clinical practice.

There have been many driver gene abnormalities identified in NSCLC, and the development and clinical adoption of targeting drugs for such are progressing. This has, as a result, complicated the situation surrounding companion diagnostics (CDx). Lung cancer treatment guidelines recommend the use of Multiplex testing that allow for CDx for many driver gene abnormalities to be used prior to 1L treatment for advanced lung cancer. The problem is that insurance rules stipulate that only one of Multiplex test is deemed reimbursable per junction in time, particular CDx are linked to particular targeted drugs instead of particular driver gene abnormalities, and none of the currently available Multiplex tests contain the CDx for all genetic mutations for which drugs have been approved. This results in a fair number of cases in which regulatory issues ensue. It is also very difficult to obtain enough of a tissue sample to get accurate results in Multiplex testing for advanced NSCLC. CDx are not full-proof, as results must be interpreted with a consideration of the potential for a false-negative due to the nature of tests. This paper, therefore, will focus on the issues with CDx from the viewpoint of medical oncologists in the clinical setting.

Objective: To review the historical aspects of compensation system for workers with pneumoconiosis who developed lung cancer., Methods: Materials and papers published on the compensation system as discussed in administrative meetings were utilized., Results: Legal claims for compensation for lung cancer among individuals with pneumoconiosis increased during the period of rapid economic growth in Japan. A possible causal relationship between pneumoconiosis and lung cancer in workers has been discussed by committees of specialists. The Expert Committee on Pneumoconiosis and Lung Cancer in 1978 did not find a causal relationship between them. However, a survey of physicians specializing in pneumoconiosis revealed medical disadvantages among individuals diagnosed with pneumoconiosis who developed lung cancer. The Ministry of Labour announced the risk of work-related lung cancer in patients with advanced pneumoconiosis (class IV or equivalent severity). Since then, numerous lung cancer patients with pneumoconiosis have been adjudicated. In 1997, the International Agency for Research on Cancer (IARC) re-evaluated the carcinogenicity of silica and declared it to be a Group I carcinogen in humans. The Expert Committee on Compensation of Lung Cancer Cases Developing from Pneumoconiosis discussed the IARC evaluation but did not accept this classification. However, the Committee of Occupational Exposure Limits in the Japan Society of Occupational Health upheld the IARC evaluation of silica as a Group I carcinogen. Because the Expert Committee of Medical Disadvantage of Lung Cancer Patients with Pneumoconiosis accepted the increased risk of lung cancer in patients with class III or equivalent severity pneumoconiosis, the Ministry of Labour announced worker compensation for such patients. The Expert Committee of Health Control of Pneumoconiosis Complicated with Lung Cancer reported in 2002 that a meta-analysis revealed no increased risk of lung cancer among workers exposed to crystalline silica; however, there was an increased risk of lung cancer in patients with pneumoconiosis. The Ministry of Labour has added lung cancer to the list of complications from pneumoconiosis and, if necessary, regular medical checkups for lung cancer. After Leaving dust work, the Health Care System provides for workers who are diagnosed With class II or higher pneumoconiosis. Therefore, if an individual with pneumoconiosis develops class II or higher lung cancer, that individual becomes eligible for workers' compensation., Conclusions: The conclusion of the Expert Committee in 2002 and the decision of the Ministry of Labour to add lung cancer to its list of complications of pneumoconiosis are evaluated to be appropriate.

"Tobacco harm reduction" is defined as a method to minimize harm and risk of death and disease without eliminating tobacco and nicotine use. In Japan, where heated tobacco products (HTPs) are prevalent, the tobacco industry is progressively endorsing the concept of "tobacco harm reduction." Therefore, stakeholders in tobacco control must urgently share perspectives and experiences surrounding this issue.　This discussion paper aimed to propose four requirements for effectively implementing "tobacco harm reduction" as a public health measure: (1) disease risk reduction, (2) cigarette smoking cessation, (3) no additional public health concerns, and (4) regulatory authorities held by health agencies, and compile information on them regarding nicotine-containing electronic cigarettes (e-cigarettes) and HTPs. Another aim was to summarize policies related to "tobacco harm reduction" adopted by an international organization (World Health Organization (WHO) and health authorities in foreign countries (the United States of America (USA), the United Kingdom (UK), Australia, Italy, and the Republic of Korea) to explore the implications of these requirements on Japan's approach. Regarding the first three requirements, scientific evidence indicated that e-cigarettes offers some level of risk reduction and can assist with cigarette smoking cessation. The potential uptake of e-cigarettes among youth and their possibility to serve as a gateway to combusted cigarette use is a concern, though a definitive causal link is yet to be established between the uptake of e-cigarette in youth and the subsequent use of different tobacco products. There is insufficient scientific evidence for any of the three requirements for HTPs. Regarding the official policies, WHO took the position that the same regulations should be applied to all tobacco products. Only the UK and USA officially established a health system based on the concept of "tobacco harm reduction"; even in Italy and the Republic of Korea, where HTPs are relatively widespread, health authorities denied any risk reduction by introducing HTPs. The UK officially adopted a smoking cessation policy with e-cigarettes. The USA established a modified risk tobacco product system under federal legislation enacted in 2009, whereas of June 2023, no HTP or e-cigarettes were recognized as explicitly reducing health risk. Regarding the fourth requirement, the UK and USA institutionalized "tobacco harm reduction" under health authorities' regulation independent of the tobacco industry. The introduction of a tobacco harm reduction policy in Japan should be considered only in line with health authorities' regulation and implementation of comprehensive tobacco control measures independent of the tobacco industry.

The kidneys filter the blood to excrete waste products and excess salt from the body as urine, while reabsorbing what the body needs and keeping it in the body. For this reason, when the function of the kidneys deteriorates, urine cannot be produced, and homeostasis of electrolytes and acid-bases cannot be maintained. As a result, waste products accumulate in the body, resulting in uremia and the need for dialysis induction or kidney transplant. This paper provides an overview of the neurological complications that appear in kidney disease and their treatment.

The life that a person with cancer leads is called the cancer journey. As cancer treatment advances and specialization progresses, a trend toward integrating each specialty from the perspective of the cancer journey is emerging. In this paper, we consider task-sharing and task-shifting from the perspective of integrating oncology and primary care. Although oncologists and primary care physicians have different specialties, we believe that task-sharing and task-shifting can be achieved and lead to smooth transitional care by strengthening collaboration and sharing knowledge and experience, while taking advantage of their respective characteristics as medical professionals working with people with cancer. For this purpose, I would like both oncologists and primary care physicians to collaborate with a high perspective and a broad viewpoint to improve the quality of life of people with cancer, without making it an objective to pursue their respective specialties.

Objectives: This study aimed to review the trends in "occupational health nursing research" conducted in Japan and determine research areas that need strengthening eventually., Methods: All articles published in Ichushi Web since 1903 were searched using the keywords "occupational health nursing" and "research." The 486 papers identified were extracted and categorized according to type and publication year. The research content of 194 original and review papers was categorized according to whether they addressed practical methods and abilities., Results and Discussion: According to publication type, out of the 486 papers, 230 (47.3%) were conference proceedings, whereas 194 (39.9%) were original and review papers. Among practical methods-related papers, 107 (55.2%), 86 (44.3%), and 1 (0.5%) were on general, health, and work environment management, respectively, whereas none addressed work management and occupational health education. Among practical ability-related papers, 125 (64.4%), 23 (11.9%), and 46 (23.7%) were on knowledge, technology, and competency, respectively. The overview of annual trends showed that the papers of all types have increased progressively. While conference proceedings accounted for 80% of the papers until 1992, recent proportions have shown a decrease to < 50%. Conversely, original papers accounted for < 20% of the papers early on, but observed a progressive increase, with recent proportions of > 40%. Regarding content, almost no papers addressed work environment management, work management, and occupational health education. Additionally, practical ability-related papers highlighted that although some research on technologies and competencies has been conducted, some areas remain inadequately addressed., Conclusions: In Japan, occupational health nursing papers have been steadily increasing since the first conference proceeding was published in 1980. Among papers addressing practical methods, those related to general management were most common, of which occupational health management accounted for approximately 80%, indicating efforts aimed at the development of occupational health nursing through research. Moreover, limited papers addressed work environment management, work management, and occupational health education, suggesting the need for future research. Among papers addressing practical ability, > 60% were related to knowledge, with research on competencies was only > 20%, suggesting the need for further research eventually.

We conducted a comprehensive survey of Foods with Function Claims (FFC) submitted from April to August 2022 to examine the scientific reliability of the systematic review (SR), which is the basis for functional claims. The results of the review of 611 functional claims for 398 products showed that there were 121 functionally active substances and 87 health claims (Hc) that were labeled, with some functionally active substances having multiple functions. SRs, meta-analyses, and clinical studies were submitted as the basis of functionality for 87%, 10%, and 3% of the reports, respectively. Of these SRs, 39% of the SRs included a single paper. In 67% of the SRs with a single paper included, some of the authors of the included paper and the person who conducted the SR had the same affiliation, which raises concerns about conflicts of interest. The median of clinical trial participants in papers included for SR was relatively small, 38, and the smallest total number of SRs was 6. Thus, it was shown that there are many SRs for FFC that are based on only a single paper or a small-scale clinical trial and that lack reliability as scientific evidence.

Cardiotoxicity induced by anti-cancer drugs is a significant concern for patients undergoing cancer treatment. Some anti-cancer drugs can damage cardiac muscle cells directly or indirectly, potentially leading to severe heart failure. Various risk factors, including the type and dosage of chemotherapy agents as well as patient background, contribute to the development of cardiotoxicity. Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), which enable patient-specific toxicity prediction, hold great promise in this regard. However, the practical implementation of hiPSC-CMs-based prediction of anti-cancer drug-induced cardiotoxicity still faces hurdles. One major challenge involves establishing and optimizing experimental systems for evaluating contractile dysfunction, the ultimate output of heart failure, using hiPSC-CMs. Such efforts are currently underway globally, focusing on tailoring functional evaluation systems to the characteristics of hiPSC-CMs. In this paper, we provide an overview of the contraction mechanisms of cardiac cells and introduce a method of measuring contraction that we have developed, and discuss the current status of contractile function evaluation methods using hiPSC-CMs.