Fighting lymphoma and colorectal cancer through in-depth research

Two National Cancer Centre Singapore (NCCS)-led research programmes have received a $50 million boost in funding as part of the Open Fund- Large Collaborative Grant (OF-LCG) programme from the The National Medical Research Council (NMRC), Ministry of Health (Singapore) . The two research programmes — SYMPHONY 2.0 and Colo-SCRIPT — comprised of multi-institution teams, were each awarded $25 million for research on lymphoma and colorectal cancer (CRC) respectively.

In the fight against cancer, there is emerging evidence that challenges a traditional homogeneous treatment model. More researchers are uncovering that cancer behaves uniquely in each patient, influencing its progression and response to therapy.

SYMPHONY 2.0

SYMPHONY 2.0 (Singapore Lymphoma Translational Study 2.0) is an ambitious endeavour leveraging emerging technologies to combat blood cancers. The initiative has three primary objectives. First, to develop an AI-driven platform capable of identifying optimal multi-drug combinations for patients with relapsed/refractory (RR) T cell lymphomas and aggressive B cell lymphoma. Second, to improve accessibility to CAR-T cell therapy, a promising but currently expensive treatment option. Finally, to centralise patient data for research by establishing a Lymphoma Atlas.

The team behind SYMPHONY 2.0 has already made significant strides in establishing Singapore as a hub for blood cancer research, with a particular focus on blood cancers that are more prevalent in Asian populations. Their work is crucial, as these Asian-centric lymphomas are often underrepresented in international studies.

One of the team’s key focus areas is Natural Killer/T cell lymphoma, an aggressive form of blood cancer that accounts for 15–20 per cent of lymphoma cases in Asia. By addressing this and other Asian-centric lymphomas, the researchers aim to fill a critical gap in global cancer research and treatment.

Professor Soon Thye LIM, CEO and Senior Consultant, NCCS, likens the project to an orchestra, with multidisciplinary specialists and researchers from various institutions — including NCCS, the A*STAR - Agency for Science, Technology and Research, and the Cancer Science Institute of Singapore — harmonising their efforts to advance cancer research.

Colo-SCRIPT

From 2017 to 2021, there were over 12,000 new CRC cases in Singapore, making it the most common type of cancer affecting men and women here. New evidence from patient sample and research data collected by members of the Colo-SCRIPT team shows that early CRC lesions and advanced tumours may be grouped into distinct subtypes.

Associate Professor Wai Leong Tam, Deputy Executive Director, A*STAR Genome Institute of Singapore (A*STAR GIS), and the Scientific Chair of Colo-SCRIPT, said: “It’s increasingly clear that colorectal cancer is composed of distinct molecular subtypes; therefore, patients need to be managed and treated differently. The one-size-fits-all approach should no longer be the way forward. By better understanding the underlying mechanisms of the complex disease, we will have an opportunity for early intervention to interrupt disease progression and eventually develop tailored treatment strategies that are more effective for patients.”

The colorectal cancer research programme will be a first-of-its-kind study that spans pre-cancer to advanced cancer, according to Associate Professor Iain Tan, Clinical Chair and Corresponding Principal Investigator, Colo-SCRIPT. The Senior Consultant in the Division of Medical Oncology, NCCS, and Goh Hak Su Professor in Colorectal Surgery, said: “We have brought together Singapore’s leading clinicians and scientists in colorectal cancer to pioneer a subtype-specific paradigm to find ways to effectively and efficiently prevent, diagnose and treat it.”

The first national CRC research programme will recruit 20,000 patients with early-stage CRC to develop new subtype-specific diagnostic methods and investigate the influence of genetic, environmental, metabolic and microbial risk factors. Through this, the team hopes to establish a pre-cancer atlas of medical knowledge and develop a novel non-invasive CRC detection test.

The team will then study 1,000 patients with advanced CRC to build a bio-specimen repository and extensively profile different tumour subtypes. The aim is to identify and bring new drugs to clinical trial for improved treatment outcomes in patients with advanced CRC. “We hope to find new ways of treating this group of patients, moving forward. Our multidisciplinary team will leverage their scientific expertise, as well as their clinical expertise in identifying and recruiting patients, to understand disease through patient samples, and apply both to uncover novel translational diagnostics and therapeutics,” said Colo-SCRIPT co-investigator, Professor Emile Kwong-Wei Tan, Head and Senior Consultant, Department of Colorectal Surgery, Singapore General Hospital and NCCS.

This article was first published in Singapore Health Nov/Dec 2024 issue.