SINGAPORE'S National Cancer Centre (NCC) is joining hands with a pharmaceutical giant to develop a drug to combat liver cancer, the second most common cause of cancer deaths here.
It is a feather in the cap for the NCC as medical centres are usually brought into the picture during drug trials, rather than at the development stage.
But AstraZeneca, an Anglo-Swedish firm, wants to exploit a new method the NCC has developed for testing drugs on mice.
The technique lets researchers implant cancer cells from human patients into the liver of a mouse. Traditionally, scientists would implant the cancer cells into the rodent's back, which is not an ideal testing ground.
The NCC research team led by Dr Huynh Hung will mix and match AstraZeneca's potential liver cancer drugs to see what works best in mice.
If Dr Huynh spots any winners, his colleague, oncologist Toh Han Chong, will test them on patients who have a fast-
killing type of liver cancer that has no cure.
The quick transition from mice to humans cuts the development time of drugs. What would usually take eight years to move from animal testing to human clinical trials can now be done in seven years, or sometimes less.
Dr Brent Vose, AstraZeneca's vice- president of oncology therapeutic area, said: 'This means we can get these drugs to the patient faster.'
Liver cancer is especially prevalent in Asia because of its link with the Hepatitis B virus, which is more common here than in the West.
The research will target a liver cancer that cannot be treated with surgery and for which no effective treatment exists.
East Asia has three-quarters of the world's patients for this type of liver cancer. Globally, one million people die from it every year.
In Singapore, liver cancer is the second most common cause of cancer deaths after lung cancer. Between 1998 and 2002, the last year when statistics are available, it killed about 400 people a year.
Increasingly, companies such as AstraZeneca, are using Asia as a launch pad to research and develop drugs for Asians.
Unlike firms such as Schering-Plough and GlaxoSmithKline, AstraZeneca does not have a manufacturing plant in Singapore. Other than a sales office at Suntec City, the five-year partnership with NCC and the National University Hospital represents its first major investment in Singapore.
AstraZeneca said it was impressed with the expertise in Singapore, where companies can shepherd a drug from the development stage, through clinical trials and to the market.
Said Dr Vose: 'You have a very strong science base, a very strong health-care infrastructure, a very good clinical trials environment.'
wycin@sph.com.sg
The life cycle of a drug trial
By Shobana Kesava
Phase I of clinical trials require patients to spend a certain periods of time in hospital, during which the drug tested is administered. This posed photo shows a ward for volunteers at the National University Hospital's clinical trials unit.
Reaching Out
The pharmaceutical company or hospital places an ethics committee-approved advertisement in newspapers, magazines or public places.
Volunteers also spread the word. They are encouraged to invite their friends to participate.
Seeking who?
Typically, healthy volunteers within a specified age range are required. Some trials call for volunteers with existing medical conditions like hypertension.
Women are less sought-after in case they become pregnant during the trial.
Making contact
When an interested individual calls the hotline, an informed administrator manning the 'recruitment line' answers all questions on the kind of commitment needed to get on the trial.
Health-related questions are fielded by doctors later.
Details needed
The potential participant gets an e-mail seeking personal information, including race, religion and occupation, as well as his personal and family health histories.
Prospective volunteers are asked whether this information can be stored for the researchers' use in the study.
First date
A full physical exam is carried out to ensure participants have a healthy height to weight ratio, along with some blood tests. Those who have recently taken part in other trials - usually within the last 12 weeks - or who are still involved in other trials, are not recruited.
Cycles run
Phase I clinical trials require patients to stay in a hospital - for cycles of three days and two nights, for example - during which the drug is administered.
Each stay is followed by monitoring: Volunteers have to turn up at specific times for blood samples to be taken over a one-week period. The cycle is repeated several times, with varying doses.
Checking out
The patient is reimbursed at the end of the designated duration of the trial. Those who drop out, or are no longer required, are paid on a pro-rata basis.
The amount usually ranges from $50 or so for a medical-fitness check to $3,000. The more intensive the trial, doctors say, the higher the payment.
This article was first published in The Straits Times on August 16, 2008.
