In-depth study of lung cancer mutations in Singapore patients

Dr Toh Chee Keong, a senior consultant medical oncologist at NCCS.
Dr Toh Chee Keong, a senior consultant medical oncologist at NCCS. PHOTO: BERITA HARIAN

Lung cancer can be caused by different genetic mutations, each of which responds to only a handful of drugs.

Not much is known about these mutations, but a team of doctors at the National Cancer Centre Singapore (NCCS) and Singapore General Hospital are hoping to change this.

From next year, they will be conducting an in-depth study of what mutations are common among patients in Singapore, in the hope of giving them treatment that is tailored to their needs.

It is not enough to rely on data from patients in other countries because Asian patients have different problems, said Dr Toh Chee Keong, a senior consultant medical oncologist at NCCS and a member of the team doing the study. "We know that the lung cancer in Asia - Singapore included - is quite distinct from that in the West," he said.

For instance, a particular mutation known as EGFR was found in nearly half the lung cancers in Singapore, but only in 11 per cent of cancers in the United States.

Lung cancer is among the top three most common cancers in both women and men in Singapore, with nearly 7,000 cases diagnosed between 2010 and 2014.

It is also one of the top killer cancers, and accounted for 5,732 deaths in that time period.

The team has already completed a pilot project involving 83 patients, in which 16 different mutations were found.

Each of these mutations represents a new target that doctors can use to treat this aggressive cancer, which is often discovered late.

"Overall, there is an increased need to try and comprehensively capture all these characteristics of lung cancers," said Dr Daniel Tan, who is a senior consultant medical oncologist at NCCS and also a member of the study team.

One of his patients is Madam Jamilah Tan, 47, who was found to be in the advanced stages of lung cancer in August last year. She was not responding to chemotherapy, and doctors found that she had a gene mutation known as ALK.

She was prescribed a drug that targeted the effects of the mutation and given immunotherapy treatment. She is now doing much better.

"Previously I couldn't walk very well, I lost weight and I had no energy all the time," the housewife said.

She added that, at the time, people would notice immediately that she was not well.

"But now, I've put on weight, and nobody would know that I have lung cancer," she said.

A version of this article appeared in the print edition of The Straits Times on November 15, 2016, with the headline 'In-depth study of lung cancer mutations in Singapore patients'. Print Edition | Subscribe