Cancer treatment now depends on identifying genetic changes that fuel disease progression. Genomic profiling helps match patients with targeted therapies or clinical trials, but traditional testing methods often involve sending samples to external labs, creating delays of weeks.
Recent developments in rapid, on-site next-generation sequencing reduce that wait, expanding access to precision medicine—particularly in community hospitals.
How in-house testing speeds up results
Under the conventional model, tissue samples and liquid biopsies are shipped to outside reference labs. The process—including transportation, processing, sequencing, analysis, and reporting—can take several weeks.
Sapporo Doto Hospital has streamlined this workflow by performing every step in-house. Specimen preparation, nucleic acid extraction, automated sequencing, and clinical interpretation are all integrated into a single process. For liquid biopsies, the hospital completes genomic profiling in about 27 hours.
Tomomi Yajima, deputy director of the hospital, noted that the difference is especially important for patients with recurrent cancer, where timing can determine treatment options. “Earlier access to genomic results allows treatment decisions without unnecessary delay,” he said.
The change isn’t just about speed. Automated platforms like Thermo Fisher’s Ion Torrent Genexus System handle nearly the entire process with minimal manual intervention. After sequencing, variant data is sent to a commercial reporting service, which generates structured reports summarizing therapeutic evidence, clinical trials, and treatment guidelines.
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The automation surprised Yajima. “Based on my experience with older sequencing platforms, I expected the process to be complex and labor-intensive,” he said. “Instead, it required almost no hands-on work.”
Japan’s reliance on overseas labs slows progress
A major obstacle to genomic testing access in Japan isn’t technical but structural. Many tests are still performed abroad. Samples are collected domestically, sent overseas, and returned for review by an expert panel before doctors can use the results.
Yajima explained that this multi-step process extends turnaround times.
The in-house model avoids these setbacks, but adoption remains limited. Many clinicians and administrators still assume genomic testing is too complex for routine use, unaware that automated platforms have simplified the process.
Which cancers benefit most—and who gets left behind
Rapid sequencing can be used for many cancer types, but lung and breast cancers see the most immediate advantages. Both have multiple targeted therapies already in use. Blood cancers are also advancing, with genomic profiling used for diagnosis, treatment selection, and monitoring residual disease.
Patients with recurrent or advanced cancers, rare cancers, or cancers of unknown origin gain the most. In these cases, genomic profiling often provides useful information when standard treatments fail.
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Access remains unequal. Reimbursement challenges and upfront costs create hurdles, but Yajima believes education is the bigger issue.
“The main problem is that many don’t know it’s available or how to use it,” he said. “Most still think of genomic testing as a complicated process.”
If adoption increases, the gap between academic centers and community hospitals could shrink. Automated platforms don’t require specialized labs—just a physician with basic knowledge of genomic medicine.
This shift could make precision oncology standard practice. Policy changes, funding reforms, and infrastructure updates are all necessary to integrate genomic testing into routine cancer care.
The technology exists. The challenge is ensuring patients and doctors know it’s an option.
Three key areas need improvement to make precision oncology widely accessible: policy, funding, and infrastructure.
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Current policies often limit genomic profiling to patients who have already tried standard treatments. Yajima argues it should be part of initial care. “It should be included when treatment decisions are first made,” he said.
Funding presents another obstacle. Testing costs remain high, and reimbursement systems don’t always cover its use. Without financial support, hospitals may hesitate to invest in the technology.
Infrastructure also requires updates. Traditional testing depends on centralized labs or specialized facilities. Automated platforms, however, can operate in community hospital labs, reducing the need for external expertise. This could expand access—but only if hospitals adopt the technology.
Yajima remains hopeful. “Every cancer patient should have timely access to genomic information as part of routine care,” he said. “We’re not there yet, but progress is being made.”
The system must adapt to keep pace with the technology.
