近畿大学医学部・病院50周年史
Survey or Interview西尾 和人

近畿大学の活力は臨床研究
患者のための研究をこれからも

With clinical research at its core
— Kindai University advances patient-focused discoveries for the future.
NISHIO Kazuto

Dean, Faculty of Medicine

All for the sake of the patients — mastering ‘basic medicine’ to connect it to clinical practice.

NISHIO Kazuto was appointed professor of the Department of Genome Biology at Kindai University Faculty of Medicine in 2006.
“Genome biology,” is a field of molecular biology that analyzes genes at the DNA level to uncover the causes of disease and to develop new therapies.
At his previous post at the National Cancer Center, NISHIO had devoted himself to one line of research in particular: that of investigating resistance to the anticancer drug cisplatin. Cisplatin is widely used in the treatment of testicular cancer, ovarian cancer, bladder cancer, and more. But like so many anticancer agents, cisplatin becomes less effective over time as cancer cells adapt and develop “resistance.”
“What I was studying then was signal transduction,” he recalls. “At the time, it was considered a niche area of research.”
Signal transduction refers to the intricate pathways of information transfer within and between cells, pathways that cancer cells hijack to proliferate, survive, invade, and metastasize. Few researchers were working in the field then. But NISHIO’s work took on new importance with the advent of molecularly targeted therapies.
These drugs act by pinpointing proteins and enzymes that drive cancer development and cell growth, shutting down the specific pathways that allow tumors to thrive. Applied to NISHIO’s field, molecularly targeted therapies block the “key molecules” in abnormally activated signal transduction pathways, thereby suppressing cancer growth.
The pioneer among them was gefitinib (marketed as Iressa), developed from AstraZeneca. Gefitinib belongs to a class known as EGFR inhibitors (Epidermal Growth Factor Receptor–Tyrosine Kinase Inhibitors, EGFR-TKIs). EGFR itself is a protein involved in cell growth, and mutations in the EGFR gene determine whether gefitinib is effective.
“When gefitinib works, it works astonishingly well—but resistance always develops. I created gefitinib-resistant cell lines and studied the mechanisms behind that resistance,” NISHIO recalls.
What had once been a niche line of inquiry had become the cutting edge of oncology. In 2002, gefitinib was approved in Japan ahead of the rest of the world for use in patients with “unresectable advanced or recurrent non–small cell lung cancer.”
“The very first clinical research on Iressa anywhere in the world was being carried out by the group at Kindai University Faculty of Medicine,” he says with pride.
It was no coincidence that these early trials of new drugs were conducted at Kindai University. The university’s Fourth Department of Internal Medicine had developed into one of Japan’s first full-fledged Departments of Medical Oncology, organized to treat cancers across organs rather than within a single specialty.
“Kindai Professors FUKUOKA Masahiro and NAKAGAWA Kazuhiko had already been conducting collaborative research on EGFR through the West Japan Oncology Group (WJOG), a multi-institutional clinical trial network,” NISHIO explains.
These professional ties and the university’s pioneering role in clinical oncology research ultimately drew NISHIO to Kindai University.

With the desire to deliver better healthcare to remote areas, I went to the Cancer Center.

NISHIO was born in 1961. Though his family had roots in Wakayama, they moved to Osaka, and he grew up there.
“I had childhood asthma and was always going to the hospital, so medicine was familiar to me from an early age. When I was in the fourth grade, I was even rushed there in an ambulance. That’s why I’ve always had an interest in the respiratory system,” he recalls.
He admits that his choice of medicine came through a process of elimination.
“I really liked biology and wanted to study it in the Faculty of Science. But when I consulted my father, he told me it might be difficult to find a job. One of my relatives had graduated from Wakayama Medical University and became a doctor, and he told me, ‘If you want to pursue biology, why not enter medical school instead?’”
At Wakayama Medical University, NISHIO joined the yacht club and even competed in the All-Japan Championships. “During my student days, I was completely tanned. People used to say I looked like a surfer. But the funny thing is, I actually can’t swim,” he says with a smile.
After graduating, he entered the university hospital and was assigned to the Kihoku Branch Hospital in Katsuragi Town, an inland region of Wakayama Prefecture, where he set out to become an internist.
“Because I had asthma myself, I was naturally interested in respiratory medicine. What attracted me most was the logical structure of chemotherapy for tuberculosis. At that time, Wakayama Medical University didn’t even have a dedicated department of respiratory medicine, so I decided to study at the Kihoku Branch, which had a tuberculosis ward.”
In this rural area of only about 20,000 people, NISHIO came face-to-face with the realities of rural medicine.
“Patients with tuberculosis or lung cancer were often left untreated until the disease had reached its final stages. I remember one time when a child with asthma was brought from deep in the mountains, two hours away, riding in the back of a small truck. That was when I truly realized how difficult it was for healthcare to reach some communities,” he recalls.
As NISHIO struggled with the question of how to deliver better medical care, a new anticancer drug for lung cancer—cisplatin—was introduced. This drug required patients to receive simultaneous intravenous infusion of large volumes of fluid—a process known as hydration—to protect kidney function. Without proper hydration, patients risked serious, even life-threatening, renal impairment.
“At that time, the knowledge and techniques for safe hydration with cisplatin weren’t yet widely understood. I felt strongly that something had to be done, so I decided to go to the National Cancer Center to learn the correct methods of cisplatin hydration,” he recalls.
Originally, he had planned to stay at the National Cancer Center Research Institute for just two weeks. But in the end, he never left. Surrounded by peers of his own generation, all equally absorbed in research, he found the environment stimulating and the work deeply rewarding.
“At the Cancer Center, it was research by day and games by night,” he recalls with a laugh. When their experiments ended, everyone would gather in the lab to play games. Since online gaming didn’t exist yet, they would all start at the same time and compete head-to-head. One of my colleagues used to say that the most enjoyable times of his life were kindergarten and those three years at the Cancer Center. That’s how everyone felt,” NISHIO recalls fondly.
Those years set NISHIO firmly on the path of basic research—one that would eventually lead him to Kindai University Faculty of Medicine.

Clinical questions — the drive to save the patient right in front of you becomes the engine of research.

NISHIO says that what makes Kindai University truly special—particularly in the field of medical oncology—is its culture of pursuing both “clinical practice” and “basic research” side by side.
“At some universities, the clinical and basic research labs are even housed in separate buildings. At Kindai, they are often next door to each other. There’s an environment here that naturally fosters translational research,” he explains.
Translational research refers to “bridging research”— the process of taking discoveries from basic science and applying them directly to clinical practice, whether in diagnosis, treatment, or prevention.
“After completing their clinical training, young doctors often come to our lab. As researchers, they start out knowing almost nothing—they’re like babies. But in two or three years, they grow remarkably. Why? Because they know patients. They bring their research back to the clinical setting with a motivation to help their patients. They have real clinical questions driving them,” NISHIO says.
Those “clinical questions” arise directly from the doubts and challenges doctors encounter while treating patients at the bedside. The desire to save the patient in front of them becomes the driving force of research—just as it once did for NISHIO himself.
At the core of NISHIO’s work today remains the same conviction: everything must be for the sake of the patient. One example was his role in introducing gene panel testing using next-generation sequencing (NGS).
In the early 2000s, through years of research, NISHIO and his colleagues had revealed that Iressa (gefitinib) was effective against cancers carrying specific genetic mutations. This breakthrough made large-scale genetic data analysis essential. NGS technology allows for the massive, high-speed reading of DNA and RNA sequences, enabling testing to be expanded even to mutations previously thought unlikely.
“At that time, each test cost around two million yen, which was prohibitively expensive,” NISHIO recalls. “We tried to ease the burden on patients through crowdfunding, while also lobbying the Ministry of Health, Labour and Welfare to secure insurance coverage.”
Today, genetic panel testing is covered by health insurance and has become a vital tool for many patients.
When asked when he first came to feel that his profession was truly his “calling,” NISHIO tilted his head, thought for a moment, and then answered:
“It was when I was at the National Cancer Center and was invited to move from being a research resident to becoming a staff member,” he recalls. A research resident is a special trainee engaged in both basic science and clinical research. “I agonized over it. The Cancer Center attracted the brightest people from all over Japan. Could I really hold my own there as a researcher? At the same time, I loved treating patients. I wanted to continue as a clinician as well. In the end, what swayed me was simply that I found research fun. Isn’t that what a vocation is? Something that you can throw yourself into, completely absorbed—that becomes your calling.”
In 2023, NISHIO was appointed Dean of Kindai University Faculty of Medicine, becoming only the third dean in its history to come from a background in basic research.
“My work now involves education, as well as more administrative and managerial duties. The strength of Kindai University lies in its clinical research, and I feel a responsibility to clearly set the course for its future direction,” he says.
With a wry smile, he admits the one regret is that he no longer has enough time for his own research. Yet he quickly adds that his greatest pleasure now is seeing young students and graduate students enjoying research and throwing themselves into discovery, just as he once did.