“Has Singapore made any inroads in tackling liver cancer, which has the highest rate of incidence in Asia?” I wondered. This high rate of incidence had already been noted in Singapore when our cancer registry first began in 1968. Liver cancer had taken my uncle a few years ago. He had lost a battle against Hepatocellular Carcinoma (HCC), the most common form of liver cancer, when it recurred. Usually diagnosed late with poor prognosis, it is treatable by liver resection or ablation. About 70 to 80 per cent of patients, however, are likely to suffer a relapse.
A landmark clinical trial, advised by a steering committee co-led by senior clinican-scientist Prof Pierce Chow of NCCS and SGH, has managed to reduce this recurrence, according to an October 2023 study I read in revered medical journal, The Lancet. IMbrave050, a global phase three clinical trial, had successfully done this using a combination therapy of immunotherapy drug atezolizumab and the angiogenesis inhibitor bevacizumab.
Conducted between 2019 and 2022, the trial involved 668 HCC patients, who were at high risk of cancer recurrence after surgical resection or ablation; the sample had a median age of 58 years, with people from 26 countries. Results of the trial showed that recurrence was 28 per cent lower for the group who received the combination therapy (every three weeks for up to 12 months or 17 cycles) than the group on active surveillance, which has been the standard of care for HCC patients after surgery.
Kudos to the team for their pioneering achievement! No doubt, more studies will be conducted with a larger population, but this could potentially improve health outcomes for HCC patients. I am so impressed by the impactful work of clinician-scientists in Singapore…Now I understand why they keep mentioning the importance of “from bench to bedside!”
