​Precision is the new watchword in medicine.  After all, conventional one-size-fits-all therapeutic strategies are not equally effective in all patients.

Cancer exemplifies why precision is important. Research shows that cancers that look the same may be different genetically, so the same treatment may not work for everyone.

A more targeted approach not only avoids ineffective treatments, unnecessary ill-effects, and poor use of resources, but also translates to better patient outcomes.

Duke-NUS Cancer and Stem Cell Biology (CSCB) Programme scientists, have leveraged on the partnerships between the school and institutions such as SingHealth and A*STAR to further the pursuit of personalised medicine.  This approach unifies the spectrum of medicine, from clinical care to scientific research and knowledge sharing.

Take certain cancers such as non-small cell lung cancer and chronic myelogenous leukemia (CML) for instance. A CSCB research team has found a specific gene mutation in these cancers that lead to drug resistance.

Above: Asst Prof Charles Chuah (left) and Assoc Prof Ong Sin Tiong

Dr. Ong Sin Tiong, Associate Professor, CSCB explained, “Some cancers occurring in patients who have inherited an East Asian-specific variant in the ‘BIM’ gene are less likely to respond to standard therapy.  We are studying to see if we can add additional drugs to the standard treatment to overcome the resistance.”

One of the potential drugs being studied is pyrvinium, an FDA-approved drug.  This drug is able to specifically kill cancer cells without harming normal cells, and block cancer promoting-pathways when combined with another drug.

The Academic Medicine partnership between Duke-NUS and SingHealth has provided the ideal environment and tools to make translational medicine possible.

The CSCB team has leveraged on Dr. Chuah’s established platforms to evaluate cancer stem cell activities, while his lab enables access to a large repository of patient samples.  Researchers at CSCB, such as Dr. Cheong Jit Kong, provide the expertise to identify the anti-cancer drug targets.  Together, they are able to find alternative treatment strategies at an unprecedented speed.

Similarly, Prof. Virshup’s lab has collaborated with A*STAR’s Experimental Therapeutics Centre and D3 (Drug Discovery & Development) to better target cancer.  They found that inhibiting an enzyme known as ‘porcupine’, or PORCN, prevents growth of certain cancers.

Above: Researchers from the Virshup lab (from left): Asst Prof Babita Madan, Prof David Virshup (seated) and Dr Cheong Jit Kong

These outcomes from the CSCB programme underscore the importance of collaboration in the search for targeted treatments.  By working in parallel and with the benefit of tapping the expertise of peers in both the research and clinical environment, discoveries can be made with greater speed, precision and efficacy.