Current status and challenges of cancer genomic medicine

In Japan, comprehensive genomic profiling (CGP) testing has been covered by the national health insurance system since 2019, marking six years of implementation.As of May 2025, approximately 100,000 patients have undergone CGP testing.This testing, conducted using tumor tissue or blood samples, has contributed to the identification of novel therapeutic options, accurate diagnoses, and cancer prevention through the disclosure of secondary findings.Additionally, the system for utilizing data centralized at the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) has become operational, positioning Japan' s framework to contribute meaningfully to global cancer research and care.However, the number of CGP tests performed remains suboptimal, and fewer than 10% of patients receive genome-matched therapies recommended through the testing, indicating a need for fundamental improvements including policy reform.At the same time, it is crucial to leverage the information for individual cancer types to further advance genomic medicine.The author has conducted analyses on the current state of genomic medicine in head and neck cancers, as well as the clinical significance of the resulting genomic profiles, using real-world data accumulated by C-CAT.This paper describes the current landscape, challenges, and future directions of cancer genomic medicine focusing on head and neck cancers.It is hoped that this will contribute to the ongoing advancement of genomic medicine in this type of cancer.