インタビュー
「Education Sessions:遺伝子診療における倫理・経済的問題」の座長 Kenneth Offit氏に聞く

現代は遺伝子解析の時代。2003年にヒトゲノム地図の解読が終了し,そのうち約1,000個の遺伝子が疾患と関連していることが確認され,遺伝子による診断・治療への研究熱は加速している。それに先立つこと約10年,1990年代初頭には,直腸癌,乳癌と相次いで発癌関連遺伝子が発見されているが,その当時と変わらず,今でも大きな検討事項のひとつになっているのが倫理的問題だ。「遺伝子診療における倫理・経済的問題」をテーマにした本学会の教育セッションでも,熱のこもった質疑応答が展開され,予定時刻を過ぎても質問に立つ聴講者が絶えなかった。ここでは,そのセッションの座長を務め,当時から乳癌関連遺伝子BRCAの研究や倫理的問題に取り組んでいたメモリアル・スローン・ケタリング癌センターのKenneth Offit氏に,セッション終了後,話を聞いた。
編集部 | これから遺伝子診断の重要性はいっそう増していくものと思われますが,まだまだ課題は多そうですね。遺伝子情報と向き合うとき,私たちが留意すべきことはどのような点でしょうか? |
Offit氏 | ![]() |
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right to choose:選ぶ権利
genetic test:遺伝子診断
confidentiality:秘匿事項
The major ethical issue in genetic testing relates to the individual's right to choose and that means the individual can choose to have a test, and individual can choose to know a result and not know a result. Here in the United States we have been struggling with the situation where sometimes the individual will choose not to tell a relative of a result and the question that we have to figure out is whether the doctor then has the authority to tell family members information and that’s something that I think will be very specific to each country. The United States and probably Japan may have slightly different views of the importance of the family and the confidentiality of the family versus the responsibility of the doctor.
編集部 | 近年では,どの癌腫においても分子標的薬による治療や遺伝子発現機構への関心が非常に高く,ASCOでもこれらの発表が人気を博しています。先生は今年のASCOでどのような発表に注目されましたか? |
Offit氏 | ![]() |
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molecular biology:分子生物学
inherited mutations:遺伝子変異
DNA repair mechanisms:DNA修復機構
Well, every year is an exciting year at ASCO in our area which is looking at molecular biology and treatment there were some important advances that we take note of. The one of the abstracts that we were particularly interested in, used a targeted treatment for individuals carrying inherited mutations of the breast cancer genes and ovarian cancer patients were shown to have a response to this very specific treatment that works against the DNA repair mechanisms that are involved in BRCA. A very early study, we'd heard about it, we look forward to hearing the results and they were very interesting results.
編集部 | 今後,遺伝子診療の整備や遺伝子診断法の確立に向けて臨床研究をさらに推進していくうえで,特にどのようなことが重要だとお考えですか? |
Offit氏 | ![]() |
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colleague:共同研究者
advance:進歩,前進
flow of information:情報の流れ
Now, I think, you know, I mean one of the great excitements now of doing research is to have colleagues that are in other countries and in Japan and in Europe we work very closely together. And the flow of information, I think, has allowed a much more rapid communication of our results and we look forward to more advances.