When liver cancer recurs in people
who have already undergone
surgery, there is typically not
much that doctors can do.
But a team at the National Cancer
Centre Singapore (NCCS) is
offering new patients the chance
to get personalised treatment if
cancer strikes again. For 95 per
cent of patients, this will happen
within three years.
If patients agree to be part of the
study, their tumours will be cut up
after surgery and sent to various
institutions for in-depth analysis.
This includes studying the genetic
make-up and immune profile of
the cancer, so as to better understand
what makes it tick.
Doctors hope that by the time
the cancer recurs, they will have
learnt enough about the specific
tumour to tailor treatment to the
patient’s needs.
The problem with liver cancer,
said Professor
Pierce Chow, who is
from the surgical
oncology division
at NCCS, is that it is complex
and not well understood.
What is known, said Prof Chow,
is that a number of genetic mutations
are behind every liver cancer.
However, they do not know which
ones are significant.
But by comparing samples taken
when the person was first diagnosed
with cancer and when his
cancer recurs, doctors can figure
this out.
“If I were to sample the recurrent
tumour... and compare that with
the original tumour, and we find
common mutations – these will be
the mutations that are important
for this person,” he said.
Existing drugs could then be
used to target these mutations.
“Currently, we don’t have enough
information to know who benefits
from what,” Prof Chow said.
Liver cancer is the fourth most
common cancer among men in
Singapore, with 2,264 cases between
2010 and 2014.
It is also among the top five killer
cancers for both men and women,
even though it does not fall among
the common women’s cancers.
The study will involve 100 patients,
40 of whom will be recruited
by three centres in Singapore.
The rest will come from Thailand,
the Philippines and Malaysia.
In Singapore, the NCCS, Singapore General
Hospital and National
University Hospital will be collaborating on
the study.
It will also involve four other research
institutions, including the
Genome Institute of Singapore.
Patients who are scheduled for
liver cancer surgery will be offered
the opportunity to take part.
There are no added risks, and
follow-up will be done every three
months.
The study will also pay for CT
scans, blood tests and liver function
tests.
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National Cancer Centre Singapore;
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