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Singapore Lymphoma Study (SLS)

Lymphoid neoplasms are the 5th most common cancer in males and 6th most common in females in Singapore. A rising incidence was noted which led to the beginning of the Singapore Lymphoma Study in January 2005.

Currently, epidemiology and clinical data on lymphoid neoplasms is derived mainly from Western series. An increasing body of information from our centre and collaborations with other healthcare institutions suggest that geographic localities as well as ethnicity are important factors and extrapolation of experience and data from the West to the Asian setting may have limitations. More importantly, the detailed clinical and molecular data obtained from this study will form the basis of all future research and healthcare planning.

The main purpose of study is to exhaustively evaluate the molecular characteristics of lymphoma, particular subtypes that occur at higher frequencies in Asians and subsequently to develop new biomarkers, diagnostic assays, treatment targets and novel treatment strategies, particularly against lymphoma subtypes unique to Asians.

The SLS, headed by Prof Lim Soon Thye (Head of Division of Medical Oncology and Principal Investigator of Translational and Clinical Research Programme in Lymphoma), aims to examine the clinical and pathological profile of lymphoid malignancies (non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, chronic lymphocytic leukaemia) in Singapore with respect to mode of presentation, clinical features, histologic and immunophenotypic distribution. We hope to evaluate the risk profile of lymphoid malignancies associated with lifestyle factors (e.g. fruit/vegetables, meat intake, alcohol consumption and use of hair dyes), exposure to specific infectious agents and occupational exposure to pesticides and benzene. The SLS forms a major component of the National Lymphoma Translational and Clinical Research (TCR) Program, which is supported by the National Medical Research Council (NMRC).

Lung Cancer Consortium Singapore (LCCS)

The Lung Cancer Consortium Singapore began in 2001 to provide a tissue and clinical data bank to support lung cancer research. To date, there are 1978 patients enrolled and daily screenings of potential patients conducted. Daily recruitment of screened patients and collection of tissue samples are carried as well.

The need to start up the LCCS was due to differences in the lung cancer profiles between East Asia and our Western counterparts. A higher proportion of lung cancer patients are never-smokers however, it has been found that Asians have a better survival outcome and response rates to chemotherapy. Such findings have spurred NCCS to gain a better understanding of our cancer patient profile here.

The LCCS aims to study lung cancer survival trend in the last decade for patients that come through NCCS when profiling patients’ tumours. Once profiled, the changes in survival trend with changes in therapeutic options can then be correlated and later compared with the Surveillance, Epidemiology and End Results (SEER) database.

The LCCS forms a major component of the National Lung Cancer Translational and Clinical Research (TCR) Program, which is supported by the NMRC and headed by Assoc Prof Tan Eng Huat, who is the Principal Investigator of the group.

Clinical Trials (CTE)

NCCS is at the forefront of cancer clinical research in Singapore that is aimed at developing novel and up-to-date treatments to improve the lives of patients with different cancer types, including breast, lung, nasopharyngeal, stomach, colorectal and liver cancers. We have over a decade of experience in conducting clinical trials and have completed a broad spectrum of more than a hundred clinical trials to date. Our portfolio encompasses phases I to III trials, with most studies evaluating the effectiveness of novel molecular targeted agents.

In the Division of Medical Oncology, our investigators have been actively designing the protocols for these clinical studies. They are working closely with Clinical Trials Epidemiological Sciences department (CTE), headed by A/Prof Tan Eng Huat, in the conduct of these trials.

Cancer Genetics Service (CGS)

The Cancer Genetics Service (CGS) is the clinical branch of the broader Inherited Cancer and Rare Disease Translational Research Programme. It is part of the Division of Meidical Oncology and currently headed by Dr Joanne Ngeow, a senior consultant in the Division of Medical Oncology, National Cancer Centre Singapore.

The mission of Cancer Genetics Service (CGS) is to serve as an expert base in the principles and practice of genetic and genomic medicine as a single platform for research, academic clinical practice, and education for NCCS and SingHealth. This is to ensure that personalised healthcare is based on rigorously researched and validated genetic information that can be incorporated into all healthcare decisions. The CGS serves as a self-and physician-referral-based clinical centre that provides expert genetic risk assessment for a broad array of diseases, education, genetic counselling, targeted gene testing, medical management recommendations and appropriate multi-specialty referrals. It is unique because the comprehensive clinical practice of medical genetics and genomic medicine is housed under one roof in proximity to the research on which the evidence-based practice of personalised genetic healthcare is performed. This is the first time in the history of the NCCS that a full-service genetic medicine clinical service exists.

The CGS is staffed by medical oncologists with advanced specialisation in cancer genetics. They are internationally known for their specialisation in breast, endocrine-related, gastrointestinal and urological cancers, highlighted by active and on-going contributions to cancer genetics.

The CGS carries the full suite of genetic medicine services, ranging from genetics of adult-onset disorders, such as cancer predisposition syndromes, to rare metabolic disorders. Patient visits to the CGS are set to increase with greater awareness of the role genomics plays in modern day cancer care. Common conditions seen at the CGS include Hereditary Breast and Ovarian Cancer Syndrome, Lynch syndrome, Hereditary Paraganlioma and Pheochromocytoma syndrome, Li Fraumeni syndrome and other cancer predisposition syndromes.

Experimental Cancer Therapeutics Unit (ECRxU)

The Experimental Cancer Treatment Unit (ECRxU) was set up in 2009. It is part of the Division of Medical Oncology and headed by Dr Daniel Tan, a senior consultant in the Division of Medical Oncology, National Cancer Centre Singapore.

The primary mission of ECRxU is to bring novel therapeutic options to the clinic while concomitantly advancing the understanding of cancer biology through the design of science-driven trials. Its focus is on providing a single point of engagement for the conduct of Phase 0/1/2 trials. Through this unique translational interface, ECRxU works closely with scientists in NCCS, Duke-NUS, GIS and others, in order to increase the value of Phase I trials beyond simple does-finding studies. The unit coordinates the aspects of modern drug development from target discovery and validation, xenograft drug screening, clinical pharmacology and biomarker correlative clinical trials. This includes the ability to do sequential tumour biopsies for biomarker development in certain trials. ECRxU’s core interests cover all solid tumours and lymphomas.

From conceptualisation to the execution of biomarker intense Phase I trials, ECRxU has successfully amassed more than SGD 5 million in competitive grants as well as completed more than 30 clinical trials. In 2014, 110 patients were enrolled into Phase I trials including first-in-human studies.