Treating cancer by genetics

Cancer genetics research paves the way for more effective and personalised treatment

The future of cancer treatment will be based on the specific gene changes found in cancer cells instead of the cancer location. “Personalised or precision medicine is about understanding a person’s condition at molecular level in order to know what treatment suits his or her best,” says Dr Teo Soo-Hwang, founder and CEO of Cancer Research Malaysia (CRM).

Nevertheless, according to her, the majority of cancer genetics studies done in the West are on Caucasians. “There were no large studies published about genetics of cancer in the Asian population. This basically means that we assume treatment options for Asian women are the same as Caucasian women. We cannot be sure whether this assumption is right or wrong until more research is done on the Asian population,” she states.

“CRM’s previous research found that a genetic element (A3B) that is essentially found in 10% of Europeans, are found in 50% of Asians. If one has this genetic element, it changes her risk of getting cancer and also the type of cancer she gets. Patients with this genetic element tend to have a lot of immune cells accumulated, so immunotherapy may work well for them. To ascertain whether this assumption is conclusive or not, we have won the Ungku Newton Omar grant to work with Cambridge researchers to analyse 600 tumours from the Malaysian population,” she explains.

This study, called the MyBrCa Study, is one of the largest breast cancer genetic studies in Asia and contributes to more than 100 genetic loci to help the scientists understand why some women are more likely to develop breast cancer.

“Currently, we have 3500 breast cancer patients and 3500 healthy women taking part in the research. With this material, we are able to understand in depth about Asian breast cancer. We shall be able to obtain some important data by the middle of next year,” says Teo.

Among the key scientists involved in the study are Dr Muhammad Mamduh Zabidi and Dr Pan Jia Wern. Muhammad, who returned to Malaysia upon completing his PhD in Austria which was published in one of world’s top academic journal ‘Nature’, is analysing cancer cell DNA samples to see where the mutations lie through advanced computer software. Pan, who completed his PhD from Duke University, USA, is analysing RNA molecules of cancer cells.

Both of them are dealing with over 20 terra byte of data, which is a million times bigger than a regular photograph. “There are 3 billion of DNA in a single cell. A single cancer cell may have 1000 to 100,000 ‘alphabets’ that are different compared to a normal cell. We need to find the 1000 ‘alphabets’ that are different out of the 3 billion that are the same between a normal cell and a cancer cell,” Teo explains.

“This project is intellectually challenging. Since we know very little about breast cancer in Asia, there is a huge gap that needs to be filled,” Muhammad says.

 “After my PhD I wanted to do something impactful to mankind. CRM is a great organisation in that context. In a country like Malaysia, we need more people to do the work locally in order to address locally important issues,” says Pan.

“It has always been known that there’s a lack of research in Asians. We can only address this gap if more Malaysians like them come back and contribute,” Teo echoes.

As a direct effect of the study, CRM is currently talking to pharmaceutical companies about organising clinical studies to see whether the newest drugs developed for immunotherapy may be more effective in Asian women.

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