Overview
C-CAT — Center for Cancer Genomics and Advanced Therapeutics (Japan)
What Is C-CAT?
In response to the growing need for cancer genomic medicine (CGM) data infrastructure, Japan's Ministry of Health, Labour and Welfare launched the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) in June 2018. It serves as Japan's national datacenter for cancer genomic medicine, functioning as the country's centralized repository for comprehensive genomic profiling (CGP) data from cancer patients. PubMed
How It Works
Each CGM hospital is equipped with a "C-CAT Cancer Genomic Portal" through which hospitals send clinical information to the C-CAT repository database and receive "C-CAT Findings" — a report providing clinical annotation and, where applicable, biomarker-matched clinical trials for every mutation found in a given patient. Some hospitals have C-CAT–specific pages within their electronic medical record (EMR) systems to send patient information directly. Clinical information aggregated to C-CAT includes patient background, medical history, best overall response, and severe adverse events. American Association for Cancer Research
To generate C-CAT Findings reports, a Cancer Knowledge Database (CKDB) for clinical annotation and related drugs and clinical trials was constructed and is continuously maintained. American Association for Cancer Research
Scale and Scope
Around 60,000 patients with malignant solid tumors have been included in the database as of mid-2024. The most common tumor types represented are bowel, followed by pancreas, biliary tract, and breast cancers. nih
Eligibility and Coverage
Since 2018, Japan's Ministry of Health, Labour and Welfare has designated 12 core hospitals and 461 affiliated hospitals across the country as centers for cancer genomic medicine. In 2019, comprehensive genomic profiling (CGP) was approved for national health insurance coverage in Japan and is now routinely performed for patients with advanced malignancies who have completed standard treatments.
CGP tests in Japan are limited to solid cancer patients who have finished (or are expected to finish) standard treatments with unresectable disease — meaning the patients enrolled are generally at a poor prognosis stage and resistant to prior therapies.
Approved CGP Tests
The database aggregates results from insurance-covered CGP assays. These include FoundationOne CDx (F1CDx), OncoGuide NCC Oncopanel (NOP), and FoundationOne Liquid CDx (F1LCDx).
Research Use
C-CAT aggregates the data of cancer gene panel (comprehensive genome profiling) tests covered by health insurance in Japan, and a research-use portal is available for organizations with permission from C-CAT. Data utilization services for organizations outside Japan are planned for a later date. National Cancer Center Japan
Significance
C-CAT is unique in that it links real-world clinical outcomes with genomic profiling data at a national scale within a universal healthcare system. This makes it a powerful resource for:
- Identifying population-specific genomic features (e.g., differences in Japanese vs. Western cancer genomes)
- Matching patients to biomarker-driven clinical trials
- Supporting drug development and precision oncology research
- Generating large-scale, nationally representative cancer genomics datasets
It is broadly comparable in ambition to resources like TCGA or COSMIC, but distinctively reflects the Japanese patient population within an insurance-reimbursed clinical framework.
Relevance to Gynecologic Oncology
One study used the C-CAT database to analyze the mutational landscape, tumor mutational burden (TMB), and microsatellite instability (MSI) status in endometrial, cervical, and ovarian cancers in Japanese patients. That cohort included 561 endometrial cancers, 839 cervical cancers, and 1,606 ovarian cancers — all analyzed by FoundationOne CDx (F1CDx) under health insurance coverage. medrxiv
A few important caveats about the gyne cancer population in C-CAT:
The patients enrolled were generally at a poor prognosis stage and resistant to platinum-based chemotherapies across all three gynecological cancer types — reflecting the eligibility criteria that CGP testing is reserved for patients with advanced, unresectable disease who have exhausted standard treatments. medrxiv
So while gyne cancers are represented, the data skews toward late-stage, treatment-refractory patients rather than the full spectrum of gynecologic malignancies. This is an important consideration when interpreting any findings derived from C-CAT for these tumor types.
Notes
Valuable for Asian population genomic profiles. Higher prevalence of clear cell carcinoma in Japan vs Western populations.