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Lab to boost treatment of liver cancer launched

The Straits Times by RACHAEL SEOW

It can take three to four months to determine which drugs are most effective in treating a liver cancer patient.

However, several Singapore research institutions, along with South Korea's Samsung Medical Centre, have come up with a programme that could cut this waiting time to just three or four weeks - which may prove to be a lifesaver for some patients.

The Purpose Programme's Joint Laboratory at Biopolis was launched on Monday to improve the treatment of liver cancer. It is billed as the world's first patient-specific platform for liver cancer to predict which drugs may work for individual patients. The programme is a collaboration between the Agency for Science, Technology and Research's Institute of Molecular and Cell Biology, the Genome Institute of Singapore, the National Cancer Centre Singapore (NCCS), the National University of Singapore (NUS) and Samsung Medical Centre.

Liver cancer can be treated through surgery but only 20 per cent of patients are diagnosed early enough for surgery to be an option, researchers say. This is because the majority of patients with liver cancer have no symptoms and the disease is often detected by chance through ultrasound or CT scans for unrelated problems - often in intermediate to advanced stages.

For advanced or inoperable liver cancers, patients undergo chemotherapy but it is difficult to identify which drugs to use, doctors say.

Targeted-therapy drugs and immunotherapy drug nivolumab have been shown to prolong patients' survival. Professor Pierce Chow, senior consultant of the oncology division at the NCCS, said: "There is (currently) no good therapy for liver cancer. Outcomes for these patients are significantly poorer than for other patients with breast or colon cancer for the same stage of disease."

Treating liver cancer is especially challenging as the tumours tend to vary among individuals. "The therapy has to be personalised for the patient. For liver cancer, there is an absolute absence of precision medicine, clinicians are not able to identify best drug for a particular patient," said Prof Chow.

Under the new programme, tumour samples will be taken from a patient, and the cells tested against different drugs to see which works best for a patient. To narrow down the range of drugs tested, analysis of a patient's genetic make-up is also conducted.

The programme will use Samsung Medical Centre's robotic Avatar Platform, which allows hundreds of sets of cells to be screened at the same time, unlike current research processes here which are more laborious and time-consuming - only one set of cells can be screened at a time. The most suitable drugs can be identified in three to four weeks.

Samsung Medical Centre's robotic Avatar Platform will be used for the first time in Singapore's medicine scene.Patients in the trial are from the NCCS and National University Hospital. The service is expected to benefit patients at all stages of liver cancer. Post-surgery patients could turn to this for subsequent therapy to prevent relapses.

Other benefits relate to drugs used, said Prof Chow. For example, the research could allow pharmaceutical firms to know which drugs to produce for subgroups of patients with certain genes - and lower the cost of drug development. "This will also cut down on costs of drugs for patients," said he said. "The first drug used is likely to be more effective as opposed to a trial-and-error kind of approach."