From comparing different treatment options to developing personalised treatments, scientists are looking at how they can improve survival rates for liver cancer patients.
Only recently have pharmaceutical companies and researchers begun paying more attention to the disease, experts here told The Straits Times.
This April, a $7.5 million grant was awarded by Singapore's National Medical Research Council to study liver cancer.
There are currently 13 clinical trials for the cancer being run at the National Cancer Centre Singapore (NCCS).
This is considered a "fairly high" number, given that the condition is not the most common cancer here, said Associate Professor Teoh Yee Leong, who is chief executive of the Singapore Clinical Research Institute (SCRI), which coordinates research both inside and outside the country.
FIGHTING A STEALTHY KILLER
This cancer is not easy to diagnose in the early stage and, by the time the patient presents with symptoms, it is normally too late for curative treatment. Thus, there is now a lot of focus on conducting research into liver cancer to look for better treatment approaches.
ASSOCIATE PROFESSOR TEOH YEE LEONG, on why it is so hard to treat late-stage liver cancer.
The disease is the third-deadliest cancer nationally, and only about a fifth of patients with early-stage hepatocellular carcinoma (HCC) - the most common form of liver cancer - are eligible for surgery or transplantation.
Until recently, however, very little research had been done on liver cancer compared with, say, breast or colorectal cancers, said Professor Pierce Chow, a senior consultant surgeon with NCCS and Singapore General Hospital.
"Things have changed, and we now have both the scientific ability and funding to carry out research on this cancer, which is so important to our patients," he said.
"In a way, we are making up for lost time as outcomes for liver cancer still lag significantly behind those for other common cancers."
One reason for the increased interest is that clinician scientists want to improve treatment outcomes - the disease is considered a "death sentence" for those who are diagnosed in the late stages, said Prof Teoh.
"This cancer is not easy to diagnose in the early stage and, by the time the patient presents with symptoms, it is normally too late for curative treatment," he noted.
"Thus, there is now a lot of focus on conducting research into liver cancer to look for better treatment approaches."
A team of researchers from SCRI and NCCS is leading a clinical trial to compare two treatment methods for liver cancer.
For the trial, one group of patients is treated with the oral drug Sorafenib, which curbs the ability of cancer cells to develop, while the other group is treated using a targeted radiation therapy.
Sorafenib is currently the only targeted drug approved for use against liver cancer and is commonly used for patients with an advanced form of the disease.
The trial has completed its recruitment of 360 participants from various Asian countries, including Thailand, the Philippines and Myanmar.
Researchers are now in the process of analysing the results to find out which treatment option works better, said Prof Teoh.
Results are expected to be out next year.
"Each country by itself might not have sufficient numbers of patients to analyse the research findings but, pooling together all the data collected in these countries, we can analyse the data and find out which treatment options are the best for patients in Asia," said Prof Teoh.
"Ultimately, the results will benefit not just patients in Singapore but also patients in Asia."
Separately, a team comprising clinicians and researchers from several institutions will carry out in-depth studies on the genomics and immunology of liver cancer.
Recruitment for the trial has since started.