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Primary liver cancer or hepatocellular carcinoma (HCC) imposes significant challenges to healthcare with huge unmet clinical needs. HCC is the second leading cause of cancer-related mortality worldwide in males and 80% of HCC are found in the Asia-Pacific. While early-stage HCC is potentially curable by surgical resection, liver transplantation or radiofrequency ablation, recurrences remain common and limits overall survival. Survival in intermediate stage HCC may be prolonged by loco-regional therapy in in advanced HCC by systemic therapies. Overall, clinical outcomes in HCC remain poorer than that of other common cancers due to the lack of efficacious systemic therapies. The biology of HCC is intrinsically challenging as HCC is the common end-point of a number of etiologies with different molecular pathways. In addition, significant heterogeneity also exists within the same tumor. 

Concerted research through an inter-disciplinary approach is thus required to address these challenges. The Program in Translational and Clinical Liver Cancer Research in NCCS initiates and coordinates a multi-national and multi-institutional enterprise with NCCS leading translational research platforms and prospective clinical studies in HCC. Nested within the program is the Secretariat of the Asia-Pacific Hepatocellular Carcinoma (AHCC) Trials Group (17 countries, > 50 sites) which has just completed enrolment of a 2500-patient, 33-site real world data Asia-Pacific HCC Registry (AHCC 08). The AHCC trials group is also currently conducting a 5-country prospective multi-omics study in surgically resected HCC cohort (AHCC 07). In our translational research platforms, we collaborate closely with leading research institutes including the Genome Institute of Singapore (GIS), the Institute of Molecular and Cell Biology (IMCB), Singapore Phenome Centre (SPC), the Translational Immunology Institute (TII), Duke-NUS, Cancer Science Institute (CSI) NUS, Singapore Bioimaging Consortium (SBIC), the Institute for Infocomm Research (I2R) and Samsung Medical Center, South Korea. This multi-institutional collaboration brings together different world-class scientific expertise to bear on the challenges of HCC. 

Our current portfolio of clinical studies and translational research platforms include: 

• Decoding global gene expression in Liver Cancer through Deep Learning and standard-of-care Clinical Imaging. Translational Research in collaboration with I2R supported by A*Star.
• Comprehensive interrogation of the epigenetics promoter and enhancer landscape in HCC to identify aberrant regulatory mechanisms associated with HCC. Translational Research in collaboration with GIS supported by NMRC CS-IRG grant. 
• The use of LiverMultiScan in the analysis of MRI scans in HCC for improved monitoring of patients’ prognosis and selection of therapy. Investigator-Initiated prospective Clinical Study in collaboration with Perspectum Diagnostics. 
• A Prospective Study to develop a Genomics-Immunomics-Phenomics Platform for Precision Medicine in HCC. Translational Research in collaboration with GIS, TII and SPC supported by NMRC CSA grant. 
• Predicting survival after surgical resection for entire spectrum of anatomically resectable HCC: a Metro-ticket approach. Investigator-initiated Clinical Study in collaboration with Duke University Medical Center. 
• A Patient-Specific Diagnostic and Predictive Platform for Precision Medicine in HCC – the PurPOSE Program. Translational Research in collaboration with IMCB, NUS and Samsung Medical Centre supported by BMRC Industry Alignment Fund Pre-positioning Grant.
• Hepatocellular Carcinoma Registry in Asia (AHCC08) in collaboration with the AHCC Trials Group. Investigator initiated clinical study in collaboration with IQVIA. 
• Precision Medicine in Liver Cancer across an Asia-Pacific Network (AHCC07) – the PLANET Study Investigator initiated multi-omics multi-national prospective cohort study in collaboration with the AHCC Trials Group supported by NMRC Translational and Clinical Research Grant.
  
  

Selected publications:

1. Chow, P.K.H., Gandhi, M., Tan, S.B., Asia-Pacific Hepatocellular Carcinoma Trials, G., et al. (2018). Sirvenib: Selective Internal Radiation Therapy Versus Sorafenib in Aisa-Pacific Patients with Hepatocellular Carcinoma. J Clin Oncol 36, 1913-1921.10.1200/JCO.2017.76.0892 
2. Lim C.J., Chow, P.K.H., Albani, S., Chew, V., et al. (2018). Multidimensional Analyses Reveal Distinct Immune Microenvironment in Hepatitis B Virus-Related Hepatocellular Carcinoma. Gut. 10.1136/gutjnl-2018-316510. 
3. Chew V., Albani, S., Chow, P.K.H., et al. (2018). Immune Activation Underlies a Sustained Clinical Response to Yttrium-90 Radioembolization in Hepatocellular Carcinoma. Gut. 10.1136/gutjnl-2017-315485 
4. Zhai, W., Foo, R.S., Chow, P.K.H., et al. (2017). The Spatial Organization of Intra-Tumour Heterogeneity and Evolutionary Trajectories of Metastases in Hepatocellular Carcinoma. Nat Comm 8, 4565. 10.1038/ncomms14565. 
5. Chew V., Albani, S., Chow, P.K.H., et al. (2017). Delineation of an Immunosuppressive Gradient in Hepatocellular Carcinoma using High-Dimensional Proteomic and Transcriptomic Analyses. Proc Natl Acad Sci USA 114, E5900-E5909. 10.1073/pnas.1706559114.