A Singapore-based team on a mission to create customised therapies for individual liver cancer patients has been awarded a $7.5 million grant to continue its studies.
It is researching the most common type of liver cancer, hepatocellular carcinoma or HCC, to understand the genetic changes that cause it, and how the cancer cells function, evolve and evade the body's immune system.
Liver cancer is the third deadliest form of cancer and patients who are not treated die within six months. Yet, it is also difficult to treat as the tumours can vary enormously.
A pilot study by the team on 12 patients over the last two years found that different parts of the same cancer had different genetic mutations.
This means the current approach to drug development, targeting a single mutation, is not adequate, said Professor Pierce Chow, a senior consultant surgeon with National Cancer Centre Singapore (NCCS), announcing the award yesterday .
He will lead a multi-disciplinary team of clinicians and scientists from several institutions to study 100 HCC patient samples from five cancer centres in Singapore, Malaysia, Thailand and the Philippines.
The grant is from Singapore's National Medical Research Council's TCR Flagship Programme and will involve the NCCS, SingHealth, the Genome Institute of Singapore, National University Health System and the Cancer Science Institute of Singapore.
The team will take tissue samples from different parts of the cancer, conduct CT scans, and collect DNA and circulating tumour cell samples from the patients at different points in time.
The cancer cells will also be grown in the lab to create pre-clinical models, which can be used to test drugs.
From the models, the researchers will also be able to study how the cancer cells evolve.
The study will start in the third quarter and be completed in three to five years.
The effort could enable doctors to predict the outcome of therapies and help them select those appropriate, said Prof Chow.
"For example, if there is a mutation that is present at diagnosis and again at recurrence, that could be the 'driver mutation' and targeting that in that patient will likely bring about good outcomes," he said.
Liver cancer is the fourth most common cancer among men here. Between 2010 and 2014, 2,254 men were diagnosed with it. It is less common in women.
Between 2010 and 2014, 2,516 people died from this form of cancer. In Singapore, 500 new liver cancer patients are diagnosed each year, 95 per cent of whom have HCC.