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Liver cancer patients wanted for new clinical trial

SINGAPORE — A new way of treating liver cancer — which combines two existing treatments — is now on trial, with researchers from four medical institutions seeking patients to join the study.

The National Cancer Centre Singapore holds clinical trials of novel therapies that liver cancer patients can participate in. Photo: NCCS

The National Cancer Centre Singapore holds clinical trials of novel therapies that liver cancer patients can participate in. Photo: NCCS

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SINGAPORE — A new way of treating liver cancer — which combines two existing treatments — is now on trial, with researchers from four medical institutions seeking patients to join the study.

The treatment strategy being tested, dubbed a world first by the researchers, sees a patient being treated with both radioembolisation and immunotherapy.

The current treatment for liver cancer patients is Yttrium-90 (Y90) radioembolisation, which involves putting radioactive isotopes into blood vessels that feed a tumour, delivering radiation to the tumour.

Immunotherapy involves activating the body’s immune system to fight cancer cells.

By combining the two, researchers hope to boost outcomes.

Radiation improves T-cell infiltration in tumours, allowing the T-cell to kill the tumour, while Nivolumab, an immunotherapy drug, helps to block a certain protein on T-cells, thus activating the T-cells to find and kill cancer cells.

“We can just give you Y90 and that’s it, but we’re saying, look, we think that if we give you Nivolumab (as well) we can further enhance (survival rates). We already know the effects of Nivolumab alone. We hope that adding (both) would further enhance (the results),” said Dr Choo Su Pin, a senior consultant medical oncologist with National Cancer Centre Singapore (NCCS) and lead principal investigator of this study, during a press conference yesterday.

Liver cancer is the second most common cause of cancer mortality in South-east Asia, and ranks among the top five cancers for men in Singapore.

The trial is a collaboration between NCCS, Genome Institute of Singapore, Singapore General Hospital and Singapore Immunology Network.

It is supported by the Ministry of Health’s National Medical Research Council, pharmaceutical giant Bristol-Myers Squibb — which developed Nivolumab — and life sciences company Sirtex.

The researchers are looking for 40 patients with cancer in the intermediate stage, as early-stage liver cancer can typically be treated with surgery or a transplant. So far, one patient has been recruited.

Patients undergoing the trial will pay for the radioembolisation treatment and fees for consultation and scans.

Nivolumab, which reportedly costs US$12,500 (S$17,600) a month, will be provided for free.

A patient will first undergo Y90 radioembolisation, followed by a dose of 240mg of Nivolumab about three weeks after. The drug will be taken every two weeks thereafter.

Y90 radioembolisation has a median survival rate of one to one-and-a-half years. According to data collected as of June last year, Nivolumab has a 13 per cent response rate, meaning 13 per cent of patients either saw their cancer disappear or partially disappear. The median survival rate is about 14.4 months.

Dr Choo said the hope is to double the response rate to 30 to 40 per cent.

Those who wish to participate in the trial may contact the NCCS Clinical Trial Office at chong.huishan [at] nccs.com.sg. JEONG HONGBIN

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