National Cancer Centre Singapore

At 18, I signed on for the MBBS/PhD programme overseas on the A*STAR National Science Scholarship. Clinician-scientists were rare in Singapore then. There were no defined training pathways available, but the world was our oyster! I spent my youth in the University of Cambridge at Medical School, the Addenbrooke's Hospital and in the labs of the Medical Research Council (MRC) UK's Cancer Cell Unit (as well as some pubs in London). It was a life-defining period of my life. The training I received, and the lifelong friends and colleagues I met shaped who I am today. Much in Singapore has changed and today we have more insight into what it takes to develop and train specialist clinician-scientists. When I returned to Singapore, I dove headlong into honing my craft as a clinician. I trained at KKH, NUH and SGH and later specialised in Medical Oncology at NCCS, where science, medicine, communication, and the whole multidisciplinary team converged. The practice of oncology, as demonstrated by senior medical oncologists who were my mentors, is truly an art. I owe my seniors and colleagues a lifetime of gratitude for their guidance. Today, my team’s research is driven by our patients’ needs. We focus on the rarer cancers, which tend to occur in younger people and make up 25% of all cancers globally. Because much is unknown, outcomes are invariably poor. My team together with our clinical, scientific and industry partners, seek to do more for individuals affected by this devastating disease. We have developed an app to help oncologists predict survival outcomes with different treatment modalities in Sarcomas. We found a novel drug combination highly effective in Soft Tissue Sarcomas in patient-derived models which we will bring to clinical trial. We also identified risk factors that predispose one with a diagnosis of a rare cancer to be at higher risk of adverse psychological outcomes like depression and suicides, enabling better support for these vulnerable patients. Our work translates into action to improve patient management. We want to match patients to effective therapies and the support they need, to change the entire trajectory of their disease. - Asst Prof Valerie Yang, MB BChir, PhD, Consultant, National Cancer Centre Singapore SingHealth #AMRIcommemorates #worldcancerresearchday #cancer #researchers #Singapore #AMRI #celebratingresearch #innovatetoaccelerate #researchinaction #impactfulresearch

In primary school, I was never that strong in Science, I preferred to draw and gift my friends my art. In secondary school, I embraced drama and debate, then later I really loved reading International Baccalaureate Philosophy, English Lit and Theory of Knowledge. I used to dream of being a writer or filmmaker! It was only later that I decided to study medicine. During my medical studies at the University of Cambridge School of Clinical Medicine there was a deep academic culture of marrying Science with Clinical Medicine and so many great clinician-scientist role models to look up to. Next to our School was the legendary MRC Laboratory of Molecular Biology, which boasted 13 home grown Nobel Prizes in Medicine & Physiology and in Chemistry and 12 more from its alumni. I saw firsthand the enormous power of scientific discoveries to transform human health, which left a deep impression. In the 1990s, basic and translational research in Singapore was nascent, but starting to grow roots and shoots. In 30 years, advancements in cancer research have been astounding. Some previously incurable cancers can now be cured. The fulfilment of being a clinician-scientist is knowing that research can potentially improve the lives of our own patients and others. In oncology today, we need to more than ever understand the language of science, how cancers grow and spread, the long and growing drug choices to treat them and their wide diverse mechanisms of action. In my area of cancer immunology and immunotherapy, even patients who used to have little hope of long survival can now potentially lead meaningful lives for years. An example is a Scandinavian patient with advanced colon cancer we treated at the National Cancer Centre Singapore after his oncologist said there were no more treatments left. We offered him a cancer vaccine on a compassionate use programme. He eventually returned home and we did not hear from him till ten years later when he wrote back to say that he remained well, and cancer-free! Another is a Singaporean patient with stage 4 liver cancer with spread to the lungs who enrolled into a combination immunotherapy clinical trial in 2018. Today he is cancer-free, living life to the fullest and still running at least 5 km daily at the grand age of 87 years old! Such stories of hope and inspiration are a testament to the depth and dedication of cancer research over so many decades. - Prof Han Chong Toh, Deputy Chief Executive Officer (Strategic Partnerships) & Senior Consultant, National Cancer Centre Singapore SingHealth #AMRIcommemorates #worldcancerresearchday #cancer #researchers #Singapore #AMRI #celebratingresearch #innovatetoaccelerate #researchinaction #impactfulresearch

A broad range of biomedical research, conducted by wet bench scientists, epidemiologists and clinician-investigators underpins cancer treatment. It is important for clinicians treating cancer patients to engage in research whenever possible as they are uniquely positioned to both identify bottlenecks in clinical treatment and conceptualise, plan and conduct the research necessary to address these gaps. Identifying the challenges in tackling complex diseases such as cancer, may not necessarily be intuitive to non-clinicians. The delivery of radioactive microspheres via an artery to treat patients with locally advanced liver cancer (radioembolization) is an established clinical practice. We noticed that while the half-life of these radionuclides (yttrium 90) is short (about 2.5 days), the treatment effects last for several months. We hypothesised that in addition to radiation damage, radioembolization also triggers a persistent immunological response. We conceptualised and conducted a prospective study at the National Cancer Centre Singapore (NCCS) investigating immune cells in liver cancer before and after radioembolization. Our study showed significant upregulation of immune cells in both the blood and the liver cancers which peaked one month after treatment published our findings in one of the top medical journals, Gut, in 2018. Four years later in 2022, another group in Milan, Italy confirmed the results in an independent study. We were jubilant! A current standard-of-care treatment in advanced liver cancer is immunotherapy using drugs called check-point inhibitors. We proposed to leverage on the up-regulation of immune cells following radioembolization. At NCCS, we conceptualised and proposed a randomised controlled trial, in which patients with locally advanced liver cancer, after radioembolization, would be randomised to receive either immunotherapy or placebo. The companies manufacturing the therapeutics provided NCCS with the funding and therapeutics required for this novel study. This clinical trial is now ongoing and enrolling patients in four countries in the Asia-Pacific region, namely Singapore, Taiwan, South Korea and China. - Prof Pierce Chow, Senior Consultant, National Cancer Centre Singapore SingHealth #AMRIcommemorates #worldcancerresearchday #cancer #researchers #Singapore #AMRI #celebratingresearch #innovatetoaccelerate #researchinaction #impactfulresearch