Novel combined therapy shows promise for controlling metastatic breast cancer

Study finds drug combo better controls advanced breast cancer

Researchers from National University Cancer Institute, Singapore (NCIS) and Cancer Science Institute of Singapore (CSI Singapore) at National University of Singapore found that combining two drugs, letrozole and lenvatinib, might help those with advanced-stage breast cancer better control the disease. Letrozole is an anti-hormonal drug, while lenvatinib was already approved by the United States for use in treating various other cancers. Half of those given the combined therapy saw their tumours shrink or experienced good control of the disease for more than six months. The study’s lead investigator, Prof Lee Soo Chin, Head and Senior Consultant, Department of Haematology-Oncology, NCIS, and Senior Principal Investigator at CSI Singapore, said that an ongoing trial was comparing the combination against standard treatment. 

Media reports also interviewed Mdm Lim Hay Eng, who was administered the treatment between January 2020 and February 2022 when she experienced a relapse of her breast cancer. The treatment resulted in a tumour in her liver shrinking by about 30 per cent within a few months, and helped control its growth while she was on the trial. 

CNA938 Singapore Tonight interviewed Dr Joline Lim, Consultant, Department of Haematology-Oncology, NCIS, and co-investigator of the study. Dr Lim explained that as both letrozole and lenvatinib could be taken orally, the therapy does not require patients to be hospitalised and reduces their outpatient appointments at the hospitals. Patients also generally experience less side effects compared to chemotherapy, such as having hair loss or low blood count issues.  

• The Straits Times Online, 24 June 2022, Drug combination could be less invasive for breast cancer, study finds 
  

• CNA Singapore Tonight, 10pm, 25 June 2022, Drug combination could be less invasive treatment for breast cancer, study finds
  

• Channel 8 Hello Singapore, 6.30pm and News Tonight, 10pm, 24 June 2022, 研究：结合口服激素疗法和抗癌药物能协助末期乳癌病控制病情 (Study: Combining oral hormone therapy and cancer drugs can help control late stage breast cancer)
  

• Mediacorp 8world News and Capital 95.8FM News, 25 June 2022, 研究：结合口服激素疗法和抗癌药物能协助末期乳癌病控制病情 (Study: Combining oral hormone therapy and cancer drugs can help control late stage breast cancer)
  

• BERITA Mediacorp Online, 24 June 2022, Hasil ujian kaedah baru dapat tangani barah payudara dengan lebih baik (Study finds novel drug combo can better control advanced breast cancer)

• Lianhe Zaobao, Page 8, 25 June 2022, 两机构联合研究：副作用较少 混合口服疗法可更有效控制晚期乳癌 (Joint study between two institutions: Less side effects, combined oral therapy can be more effective in controlling advanced breast cancer)
  

• Shin Min Daily News, Page 6, 24 June 2022, 乳癌化疗严重副作用  使用新口服药物 妇女生活获改善 (Severe side effects due to chemotherapy; New oral therapy could improve the quality of life of women with breast cancer)

• Berita Harian, Page 4, 25 June 2022, Kombinasi dua ubat dapat bantu pesakit barah buah dada kawal penyakit (Combined drug therapy can help patients with breast cancer better control the disease)
  

• Tamil Murasu Online, 25 June 2022, மார்பகப் புற்றுநோய்க்கு பலன்தரும் சிகிச்சை: ஆய்வு (Effective treatment for breast cancer: study)

• Newsbeezer, 24 June 2022, The drug combination could be a less invasive treatment for breast cancer, the study finds
  

AI platform optimises chemotherapy dose in Singapore

​National University Singapore has reported good results in employing CURATE.AI, an artificial intelligence (AI) application that helps clinicians identify appropriate and tailored chemotherapy doses for patients. The research was in partnership with clinicians from National University Cancer Institute Singapore. Clinicians were allowed to accept or reject CURATE.AI dose recommendations based on clinical judgement during the pilot trial, which ran from August 2020 to April 2022 at National University Hospital.

ALLG May 2022 Scientific Meeting Review

​Speaking at the Australasian Leukaemia and Lymphoma Group (ALLG) 2022 Scientific Meeting in May, Prof Chng Wee Joo, Director of National University Cancer Institute Singapore, discussed the available clinical and molecular methods of identifying patients with high-risk multiple myeloma. He highlighted that these strategies remain suboptimal and clinicians still fail to identify 50 percent of patients who ultimately have functionally high-risk disease. 

国大试验由人工智能推荐化疗剂量 97％获医生采纳 (NUS conducts trial to optimise personalised chemotherapy dose with artificial intelligence, 97 percent of dose recommendations accepted by clinicians)

​A research team from National University Singapore together with clinicians from National University Cancer Institute Singapore embarked on a clinical trial that leveraged artificial intelligence tool Curate.AI to give cancer patients more personalised and effective chemotherapy treatment with potentially reduced side effects. Dr Raghav Sundar, Consultant, Department of Haematology-Oncology, National University Cancer Institute Singapore and a principal investigator of the trial, said a key aim of the trial was to empower clinicians to identify the optimal dose for each patient, without adding to their workload. In this way, clinicians can focus more on the patient and caregiver.

• Mirage, 13 June 2022, NUS AI platform enables doctors to optimise personalised chemotherapy dose
  

AI platform could allow doctors to reduce chemotherapy drug dose for cancer patients

​An National University Singapore research team led by Prof Dean Ho from the National University Singapore College of Design and Engineering embarked on a clinical trial, called Precise. Curate, to prove that Curate.AI can work in real-world settings. Curate.AI is an artificial intelligence (AI) tool that prescribes patients with the most optimal drug doses throughout the course of their chemotherapy such that they receive maximum results with minimal side effect. The trial spanned from August 2020 to April 2022 and was conducted in collaboration with clinicians from National University Cancer Institute Singapore, which is part of National University Health System. It involved 10 patients with advanced solid tumours, many of whom had stage-four colorectal cancer.

 Dr Raghav Sundar, Consultant, Department of Haematology-Oncology, National University Cancer Institute Singapore and a principal investigator of the trial, said a key aim of the trial was to empower clinicians to identify the optimal dose for each patient, without adding to their workload. In this way, clinicians can focus more on the patient and caregiver.

国大与厦大研发纳米疫苗 消除癌症肿瘤并抑制复发 (NUS and Xiamen University develop nanovaccine to eliminate cancer tumours and inhibit recurrence)

A team of scientists led by Prof Chen Xiaoyuan, Narat Muzayyin Chair Professor in Medicine and Technology at NUS Yong Loo Lin School of Medicine, and Prof Liu Gang from Xiamen University has formulated a novel vaccine which showed high efficacy in the treatment of solid tumours. The breakthrough development prevented the relapse of tumour growth and provided immunity against similar tumour types on melanoma tumour models.

Speaking independently of the study, Prof Chng Wee Joo, Director and Senior Consultant, Division of Haematology-Oncology, National University Cancer Institute Singapore, said the innovation overcame some of the shortcomings in current technologies in the field of cancer immunotherapy and improved the effectiveness and sustainability of the immune response to these treatments. This is a significant advancement that will have important impact on patients.

• Mirage, 8 June 2022, Nanotechnology used to destroy and prevent relapse of solid tumor cancers
  

• Newsfounded, 7 June 2022, Researchers are using nanotechnology to destroy and prevent the recurrence of solid cancerous tumors
  

减少癌症误诊之法 (Ways to reduce cancer misdiagnosis)

​This is the second part of a commentary by Dr Lim Siew Eng and Dr Ross Soo, Senior Consultants, Department of Haematology-Oncology, National University Cancer Institute Singapore, in which they highlighted ways to reduce cancer misdiagnosis. These include making accurate diagnosis a priority at all levels of healthcare, and conducting research on cancer diagnostic accuracy. They also highlighted the importance of continual education of healthcare providers, as well as communication between patients, doctors and other healthcare professionals, and ensuring patients and their families are heard during the treatment journey.

常被误诊的癌症 (Commonly misdiagnosed cancers)

T​his is the first part of a commentary by Dr Lim Siew Eng and Dr Ross Soo, both Senior Consultants in the Department of Haematology-Oncology, National University Cancer Institute Singapore, in which they explained what constituted misdiagnosis of cancer and the possible reasons contributing to the misdiagnosis. For cancer, presenting symptoms can be diverse and may overlap with other common, mild illnesses, delaying an earlier diagnosis of cancer.

புதிய மருந்துகளை மனிதர்களிடம் சோதிக்கும் நடுவமாகும் சிங்கப்பூர் (Singapore sets sights on being regional centre for clinical trials)

​Singapore has set its sights on becoming a regional centre for clinical trials as this would give Singaporeans early access to new treatments and drugs. The report featured a photo of A/Prof David Tan, Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute Singapore, in a lab at National University Cancer Institute Singapore.

Clinical trials evolving as they advance treatment. S'pore sets sights on being regional centre for clinical trials, from diabetes to cancer

​In view of World Clinical Trials Day on 20 May, Straits Times spotlighted three different trials in Singapore and explored how the nature of clinical trials has changed over the years.

Dr Sue-Anne Toh, adjunct associate professor of medicine at NUS Yong Loo Lin School of Medicine, who is also leading some clinical trials on diabetes at National University Hospital, conducted one of the world's largest comprehensive scientific studies on the progression to diabetes in Asian populations.

Prof Goh Boon Cher, Deputy Director of Research, National University Cancer Institute Singapore, said that cancer diagnosis could be catastrophic for Asian households who were unable to afford it, and there needs to be a way to optimise costs that were borne by insurance and the government. Prof Goh added that one solution would be to review the dose of the drug given, as the drugs were sometimes given at higher doses in hopes of a better outcome. Prof Goh and his team started a trial to find out if halving the dose for epidermal growth factor receptor (EGFR) mutant lung cancer would achieve the same clinical benefits. Prof Goh said that such trials were hugely beneficial to patients, but has faced the lack of funding. Prof Goh said that they have hence turned to philanthropy.

Straits Times also interviewed Ms Tang, a young healthy volunteer participant in the National University Hospital diabetes study who found out she had pre-diabetes through the study, and 83 year-old Mdm Hee Poh Lian who has nasopharyngeal cancer and had gone for two clinical trials – an immunotherapy trial and later an oral chemotherapy type. Her condition has improved after both trials.

Straits Times highlighted that an ongoing study, NURTURE (NUh Repository of TissUe and data for Research in Endocrinology), is an National University Hospital initiative to build a secure biorepository of tissue and health records data for research in National University Health System. This provided resources to National University Health System' investigators for diabetes-related studies ranging from genetics and diagnosis to diets/lifestyles and clinical care treatment.

说乐龄癌症护理，从财务、心理、生活品质到预先护理计划，一一说明！(Care for senior cancer patients: from financial assistance, emotional support, quality of life to Advance Care Planning)

​Ms Vivian Luah, Senior Medical Social Worker, National University Hospital, and Ms Tiffany Soh, Principal Medical Social Worker, Ng Teng Fong General Hospital, shared how the multi-disciplinary team from the National University Cancer Institute Singapore Geriatric Oncology LongituDinal End to eNd (GOLDEN) programme at National University Hospital and Ng Teng Fong General Hospital supports senior cancer patients in their care journey. They mentioned that as medical social workers, their role is to look into the psychosocial needs of the elderly and their caregivers, which range from financial concerns to care planning and emotional support. During the FB live interview, they shared case studies to illustrate how patients who are referred to medical social workers receive various forms of assistance and support.

Healthcare • Minimum stock quantity of drug increased

​In response to a letter by a patient published alongside in Straits Times Forum on 14 May, Mr Lee Meng Tuck, Head, Operations, National University Cancer Institute Singapore, explained that the National University Cancer Institute Singapore pharmacy was unable to fulfil the patient's full prescription due to an unexpected surge in demand for a specific medication the week of her visit. However, upon knowing that the patient had a week's supply left, National University Cancer Institute Singapore followed up immediately to arrange for the medication to be delivered within a week. No other patient was affected by the incident. 

While there was an unfortunate delay in the delivery due to a miscommunication, the patient has since received the medication and there was no disruption to her treatment. National University Cancer Institute Singapore takes this matter seriously and has, with immediate effect, increased the minimum stock quantity of the medication. National University Cancer Institute Singapore has also reviewed its processes to ensure tighter communication within its team and closer monitoring of its inventory. National University Cancer Institute Singapore assured that in urgent situations, arrangements will be made with partner hospitals and institutions to mitigate sudden shortages.

• The Straits Times, 14 May 2022, Page A25, Healthcare • Hospital did not have enough cancer medicine
  

Colorectal cancer: Not only is it preventable, it is highly curable

​Colorectal cancer is the most common cancer in Singapore. Citing National University Cancer Institute Singapore, the article mentioned that colorectal cancer results in more than 1,865 cases each year.

SCG Cell Therapy announces HSA clinical trial approval of TCR-T cell therapy for liver cancer

​The Health Sciences Authority has cleared Singapore-based SCG Cell Therapy’s Investigational New Drug application for clinical trials for SCG101, an autologous T-cell receptor T-cell therapy, for liver cancer. Dr Yong Wei Peng, Principal Investigator of the study and Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute Singapore, noted that liver cancer was the third most common cause of cancer-related death in Singapore, and there are significant challenges with the available options in meeting patient needs. The SCG101 offers a novel treatment option for patients.

• Yahoo! News, 9 May 2022 

• Australian Associated Press, 9 May 2022

• The Active Age, 9 May 2022

• WorkSmart Asia, 9 May 2022

• Value Buddies, 9 May 2022