{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:04:13Z","timestamp":1792523053076,"version":"4.5.0"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Japan\u2019s Center for Cancer Genomics and Advanced Therapeutics (C-CAT) provides a national platform for studying genomic-medicine-era care. We conducted a nationwide registry\/database study to examine whether facility-level Japanese Society of Medical Oncology (JSMO) specialist availability was associated with first-line time to treatment failure (TTF) in lung cancer. The primary exposure was treating-facility JSMO specialist count (0\u20131 vs. \u22652); dual JSMO\/Japanese Respiratory Society availability was a secondary lung-cancer-oriented exposure. First-line TTF was defined from systemic therapy start to recorded first-line treatment end or death, whichever occurred first. The cohort included 5456 patients at 241 facilities: 1477 in the 0\u20131 group and 3979 in the \u22652 group. Kaplan\u2013Meier estimated median first-line TTF was 4.2 versus 5.1 months (log-rank p &lt; 0.001). In the full clinical adjustment model, the HR for \u22652 versus 0\u20131 specialists was 0.911 (facility-cluster robust 95% CI, 0.806\u20131.029; robust p = 0.133). The point estimate was in the direction of longer recorded treatment-process duration, but the robust confidence interval included no association. Linking C-CAT with facility-level workforce data demonstrates a health-services use of national genomic registry data and supports the development of chemotherapy-specific databases with patient-level, time-anchored clinical information.<\/jats:p>","DOI":"10.3390\/curroncol33080462","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:24:07Z","timestamp":1785752647000},"page":"462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Facility-Level Medical Oncology Specialist Availability and First-Line Time to Treatment Failure in Lung Cancer: A Nationwide C-CAT Registry Analysis"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-5130","authenticated-orcid":false,"given":"Shinya","family":"Kajiura","sequence":"first","affiliation":[{"name":"JSMO Secretariat Division, Japanese Society of Medical Oncology, Tokyo 105-0013, Japan"},{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7629-6803","authenticated-orcid":false,"given":"Hironaga","family":"Satake","sequence":"additional","affiliation":[{"name":"JSMO Secretariat Division, Japanese Society of Medical Oncology, Tokyo 105-0013, Japan"},{"name":"Department of Medical Oncology, Kochi Medical School, Kochi University, Kochi 783-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4205-9540","authenticated-orcid":false,"given":"Ryuji","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Board of Directors, Japanese Society of Medical Oncology, Tokyo 105-0013, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Takayuki","family":"Yoshino","sequence":"additional","affiliation":[{"name":"President, Japanese Society of Medical Oncology, Tokyo 105-0013, Japan"},{"name":"Department of Global Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00408-025-00801-x","article-title":"Update 2025: Management of Non-Small-Cell Lung Cancer","volume":"203","author":"Jeon","year":"2025","journal-title":"Lung"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"108099","DOI":"10.1016\/j.lungcan.2025.108099","article-title":"Clinical utility of comprehensive genomic profiling in non-small cell lung cancer: An analysis of a nation-wide database","volume":"200","author":"Fujii","year":"2025","journal-title":"Lung Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.21037\/tlcr.2019.11.03","article-title":"A review on the impact of lung cancer multidisciplinary care on patient outcomes","volume":"9","author":"Heinke","year":"2020","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_5","first-page":"100580","article-title":"Does Multidisciplinary Team Management Improve Clinical Outcomes in NSCLC? A Systematic Review With Meta-Analysis","volume":"4","author":"Souza","year":"2023","journal-title":"JTO Clin. Res. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"316","DOI":"10.2183\/pjab.96.023","article-title":"Cancer genomic medicine in Japan","volume":"96","author":"Mano","year":"2020","journal-title":"Proc. Jpn. Acad. Ser. B Phys. Biol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1158\/2159-8290.CD-22-0417","article-title":"C-CAT: The National Datacenter for Cancer Genomic Medicine in Japan","volume":"12","author":"Kohno","year":"2022","journal-title":"Cancer Discov."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3041","DOI":"10.1111\/cas.15833","article-title":"Human resources for administrative work to carry out a comprehensive genomic profiling test in Japan","volume":"114","author":"Kage","year":"2023","journal-title":"Cancer Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1111\/cas.16065","article-title":"Patient survey on cancer genomic medicine in Japan under the national health insurance system","volume":"115","author":"Kage","year":"2024","journal-title":"Cancer Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1093\/jjco\/hyab135","article-title":"Current status of medical oncology in Japan and changes over the most recent 7-year period: Results of a questionnaire sent to designated cancer care hospitals","volume":"51","author":"Arai","year":"2021","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.21037\/tlcr.2019.11.33","article-title":"Multidisciplinary team care in advanced lung cancer","volume":"9","author":"Kowalczyk","year":"2020","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1093\/annonc\/mdz060","article-title":"Analysis of time-to-treatment discontinuation of targeted therapy, immunotherapy, and chemotherapy in clinical trials of patients with non-small-cell lung cancer","volume":"30","author":"Blumenthal","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1080\/03007995.2023.2192610","article-title":"Time to treatment discontinuation in first-line non-small cell lung carcinoma: An overview","volume":"39","author":"Lasala","year":"2023","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/aje\/kwv254","article-title":"Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available","volume":"183","author":"Robins","year":"2016","journal-title":"Am. J. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.1111\/cas.15837","article-title":"Assessment for the timing of comprehensive genomic profiling tests in patients with advanced solid cancers","volume":"114","author":"Hagio","year":"2023","journal-title":"Cancer Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1200\/CCI.19.00013","article-title":"Characterizing the Feasibility and Performance of Real-World Tumor Progression End Points and Their Association with Overall Survival in a Large Advanced Non-Small-Cell Lung Cancer Data Set","volume":"3","author":"Griffith","year":"2019","journal-title":"JCO Clin. Cancer Inform."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1007\/s12325-019-00970-1","article-title":"Generating Real-World Tumor Burden Endpoints from Electronic Health Record Data: Comparison of RECIST, Radiology-Anchored, and Clinician-Anchored Approaches for Abstracting Real-World Progression in Non-Small Cell Lung Cancer","volume":"36","author":"Griffith","year":"2019","journal-title":"Adv. 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