10 May 2008
S'pore-US partnership to focus on tailor-made medicine
The Straits Times - pg S14

By Liaw Wy-Cin

FORGET the one-size-fits-all approach to medicine.

Predicting who will get a particular disease and how patients respond to different treatments may soon drive healthcare costs south.

To help such personalised treatments reach local patients faster, public healthcare group SingHealth has tied up with United States experts in an international project focusing on tailor-made medicine.

SingHealth, which oversees three hospitals, five national specialty centres and a network of primary healthcare clinics here, signed an agreement this week to work with a programme called the Partnership for Personalised Medicine.

Said SingHealth group chief executive Tan Ser Kiat: "Currently, medicine is being practised by a blunderbuss approach.

"For example, Panadol may appear to work for everybody who has a headache, but we now know that it does not work for about 20 per cent of people.

"So now, the question is how to tell, from the start, which 20 per cent of people it will not work for."

Developing diagnostic tools and medicine which can target more specific genetic differences among people is getting many scientists around the world excited, because it will ensure that patients get the treatments which work best for them.

Scientists agree, however, that this is a long-term approach, and it will be 10 to 20 years before such research bears fruit.

The US-based programme is led by Nobel laureate Lee Hartwell, 69, president and director of the Fred Hutchinson Cancer Research Centre in Seattle.

One of Dr Hartwell's goals is to build a centre at the Translational Genomics Research Institute in Arizona, in the US, to develop ways to more accurately spot and predict more diseases, and to predict individual patient responses to treatments.

Professor Tan said he expects more precise detection and prediction of disease and treatment response to reduce overall health-care costs, by ruling out costly and unnecessary tests, for example.

Details of Dr Hartwell's programme are still being worked out.

Proteins are becoming a hot target in the field. They are a vital component in many of the body's chemical reactions.

Some of the latest drugs on the market already target specific proteins.

For example, the breast cancer drug Herceptin is most effective in breast cancer patients with high levels of the protein called human epidermal growth factor receptor 2, or HER2.

The drug does not work as well for the 75 per cent of breast cancer patients who have low levels of the protein.

While scientists previously focused on deoxyribonucleic acid (DNA) and genes - which code hereditary information - Dr Hartwell believed proteins were better at unravelling the mystery of disease.

Speaking to The Straits Times during a recent visit here, he said: "Proteins are more dynamic and change much more than DNA. So it is easier to spot changes when disease strikes.

"DNA doesn't change over time, except in cancer."