The standardization and data sharing of genomic and phenotypic data for big data analysis in cancer genome medicine has become important. In particular, the number of genomic data being sequenced within the framework of medicine is increasing rapidly, and responsible sharing of clinical sequence data is a challenge. I outline new schemes for sharing genomic and phenotypic data, such as cloud computing, data access control through authentication, new forms of exchange of phenotypic information, and standardization of genomic data through clinical sequencing.

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With the advancement of technology for genome analysis using next-generation sequencers, comprehensive knowledge of large-scale cancer genomes has been cataloged. Using these data, a clinical sequencing for selection of therapeutic approaches based on comprehensive genomic profiling of individual cancers is becoming a driving force in precision oncology. However, the current clinical sequencing for precision oncology is a developing diagnostic tool that rarely reaches a therapeutic drug. To develop the next-generation individualized treatment for cancer, it is necessary to develop novel biomarkers, therapeutic reagents, and methods for responding to drug resistance and recurrence of cancers through deeply understanding molecular subtype and spatiotemporal heterogeneity of cancers as well as molecular mechanisms of carcinogenesis based on various omics data. Ii is also necessary to utilize liquid biopsy, which can provide information of cancer genome in non-invasive and real-time manners, and artificial intelligence technology, which is useful to reduce costs for analysis/annotation/interpretation of clinical sequence data and standardize the selection of therapeutic reagents.

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The era of personalized cancer therapy has stared by the recent introduction of cancer genomic medicine to our daily practice. Tohoku University Hospital established Personalized Medicine Center (P-MEC) in 2017 to promote the development and propagation of genomic medicine for cancer, lifestyle diseases and rare diseases. And also, our hospital and Tohoku Medical Megabank Organization cooperated with each other to start Advanced Research Center for Innovations in Next-Generation Medicine (INGEM) which was established as one of four priority research projects promoted as Designated National University. In addition, our hospital was certified as Designated Core Hospitals for Cancer Genomic Medicine in February 2019 and has played a great role in leading cancer genomic medicine in Japan. Although there are various issues in clinical use of cancer genomic medicine, such as the way to access for the treatment or the method of corresponding for germline mutation, those have been gradually overcome. Further development is expected.

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Certification of Certified Nurse Specialist in Genetics Nursing began in 2017. After being certified, Certified Nurse Specialist goes through the four processes of development, there are orientation, frustration, practice and integration. Certified Nurse Specialist has been said that it takes 5 to 3 years to reach the integration period. Current, Certified Nurse Specialist in Genetics Nursing has been their third year. In this article, to clarify the practices and challenges of Certified Nurse Specialist in Genetics Nursing using role development process.

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I am a general nurse with a Certified Genetic Counselor® qualification. So far, I have searched for genetic work in nursing work. I have been worried about what points of genetic work and nursing work can be done by all nurses in the clinical setting, and I have been worried and tried and error.The task that I feel was able to make it a habit is a collaborative system regarding family history hearing. This time, I report the contents announced at the Chairman's Planning Symposium.

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The expansion of cancer genomic medicine is ushering in dramatic changes in cancer medicine in Japan. However, the role of nurses in this new era is still unclear. To be involved in cancer genomic medicine, nurses require knowledge and experience related to cancer nursing and genetic medicine. The present manuscript considers the role of certified nurse specialists in cancer nursing from the following perspectives: interest in familial tumors encountered by the author during four recertifications as a certified nurse specialist in cancer nursing; the state of genetic counseling as observed in the United States; changes in the Plan to Promote Cancer Control; the process of obtaining the qualification of a hereditary tumor coordinator; and the current situation at cooperative hospitals for cancer genomic medicine. Development of the role of certified nurse specialists in cancer nursing will facilitate their involvement in cancer genomic medicine with other nursing professionals, thereby contributing to cancer medicine.

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Hereditary breast and ovarian cancer （HBOC） accounts for approximately 3%–5% of all breast cancers. It is important to perform primary screening to identify individuals at risk of HBOC and to provide opportunities for genetic counseling and genetic testing. Between June 2017 and November 2017, all patients who visited the breast and endocrine surgery clinic at our hospital routinely filled out the “medical questionnaire on hereditary cancer” developed by our genetic diagnosis department. For each respondent, we scored the number of criteria qualified for BRCA1/2 testing based on the National Comprehensive Cancer Network guidelines Version 1.2018 Genetic/Familial High Risk Assessment: Breast and Ovarian. The questionnaire included questions to assess the patient’s level of concern pertaining to heredity to analyze the relationship between the score and the level of concern. Of the 502 patients, 125 （24.9%） had a score of 1 or more, however there was no correlation between a high score and the level of concern regarding heredity. Thus, we should provide adequate genetic information and further genetic counseling based on this score.

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