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Narayanan Gopalakrishna Iyer
Assoc Prof Narayanan Gopalakrishna Iyer
National Cancer Centre Singapore
Division of Surgical Oncology
Senior Consultant
MBBS (Hons), PhD (Cambridge), FRCSEd, FAMS

Dr Gopal Iyer graduated top of his medical school class at NUS in 1998, with Honours. He subsequently went on to complete a PhD in molecular carcinogenesis at the University of Cambridge. He trained as a General surgeon at Singapore General Hospital and then went on to two separate head and neck surgical fellowships at Sydney Head and Neck Cancer Institute at Royal Prince Alfred Hospital, Australia and Memorial Sloan-Kettering Cancer Centre, New York, USA. At the end of his fellowship at MSKCC, he was awarded the Michael Burt award for being the best fellow in the surgical division both in terms of operative skill and research output.

Dr Iyer is a Head and Neck surgeon in National Cancer Centre and Singapore General Hospital and also a Head and Senior Consultant at SingHealth Duke- NUS Head and Neck Centre. He has extensive experience in the surgical management of head and neck cancers, as well as surgery for benign diseases in the head and neck (including thyroid, salivary gland and skin lesions). He performs complex resections and reconstructions of cancers involving the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, paranasal sinuses and neck. He is involved in the robotic and endoscopic head and neck surgical program having performed a number of these procedures locally and mentored the first ever robotic thyroidectomy in Australia in Feb 2012. He is actively involved in research and leads a number of research programs that aim to determine prognostic factors in oral cancers, identifying the cause of head and neck cancers in young people and development of novel therapeutic strategies in treating these cancers.

Research: Principal investigator of Cancer Therapeutics Research Laboratory @ 502, National Cancer Centre, Singapore

The over-arching theme in my lab is the identification of prognostic markers, novel therapeutic targets and modification of conventional therapy for head and neck cancers, through individualization of treatment modalities. This is achieved through several different approaches. Clinical research is achieved through the establishment and enrichment of good clinical databases to answer specific clinical questions and dilemmas in head and neck oncology. Biomarker discovery is focused on established technologies including expression microarray, immunohistochemistry, flow cytometry and next generation sequencing. We have also established primary cell line and stem cell models for testing of targeted compounds specific to head and neck cancers. The aim is to translate this knowledge into clinical trials and patient specific outcome in the near future.

Education

Professional Appointments and Committee Memberships
  • Founding President, Head and Neck Cancer Society (Singapore), Jul 2014

  • Associate Member, American Association for Cancer Research, Dec 2003

  • Candidate Member, American Association of Endocrine Surgeons, Jan 2010

  • Fellow Member, American Head and Neck Society, Apr 2010

Awards

·            Outstanding Faculty Award, Residency in Singhealth Excels, 2014

 

·            Soo Khee Chee Publication Award, Singhealth Foundation, 2013

 

·            Wong Hock Boon Society Outstanding Mentor Award, National University of Singapore, 2013

 

·            Clinician-Scientist Award, National Medical Research Council, 2013

 

·            Singhealth Publish Medical Research Publication Award, 2012

 

·            Proctored/supervised first ever robotic thyroidectomy in Australia at Macquarie University Hospital, Sydney on 3rd Feb 2012

 

·            SingHealth Talent Development Fund Medical Research Publication Award, 2011

 

·            Best presentation, New York Head and Neck Society Annual Meeting (co-first author, presented by Dr Luc Morris),2011

 

·            Best poster, American Association of Endocrine Surgeons (co-first author, presented by Dr Luc Morris), 2011

 

·            Young Investigator Award (Clinical Science) from Singapore General Hospital- supervisor to Brian Tian (medical student/presenter), 2011

 

·            Michael E Burt award for operative, clinical, teaching and research excellence from Memorial Sloan-Kettering Cancer Center – awarded to the best fellow overall in the Division of Surgery, 2010

 

·            Poster of Distinction, American Association of Endocrine Surgeons, 2010

 

·            Young Investigator Award (Basic Science) from Singapore General Hospital, 2006

 

·            Astra Zeneca Scholar-in-Training Award from the American Association for Cancer Research, 2004

 

·            National Medical Research Council-Singapore Totalisator Board Medical Research Fellowship Cambridge Commonwealth Trust Studentship, 1999-2003

 

·            Bachelor of Medicine, Bachelor of Surgery with Honours for distinctions in Anatomy, Biochemistry, Microbiology and Surgery , 1998

 

·            Lee Kuan Yew Gold Medal -best graduate throughout course of study for M.B.,B.S. Gibbs Gold Medal -first  in general proficiency for 4 professional exams Singapore Medical Association. Silver Medal-first in final professional examination Ciba-Geigy Prize -first in general proficiency throughout complete course of 5 years of study Second Mekie Book Prize (Surgery) -second best in surgery Nestle Book Prize (Paediatrics) -best in paediatrics clinical clerkship, 1998

 

·            Medical Alumni Association Silver Medal -first in second professional examination Beecham Book Prize (Pharmacology) -first in pharmacology, 1996

 

·            Beecham Book Prize (Microbiology) -first in microbiology, 1995

 

·            Academy of Medicine Silver Medal -first in first professional examination Oliviero Gold Medal (Biochemistry) -first in biochemistry Beecham Book Prize (Anatomy) -second in anatomy, 1994

 

·            Dean’s List , 1995-1998

 

·            University Scholarship awarded by National University of Singapore, 1994-1996

Publications and Research Trials

·         DS Tan, W Wang, PH Sew, HS Leong, DP Lau, FT Chong, SS Krisna, KH Lim, NG Iyer. Tongue carcinoma infrequently harbour common “druggable” alterations. (submitted to BMC Cancer)

 

·         CM Soon, KC Soo, HK Tan, NG Iyer. Role of fine needle aspiration cytology and frozen section for surgical decision-making in the management of parotid gland neoplasm. (submitted to ANZ J Surg)

 

·         B Tian, HS Leong, KC Soo, R Sivanandan, NG Iyer. Head and neck squamous cell cancers with high stem cell fractions ab initio have poor outcomes. (Submitted to BMC Res Notes)

 

·         HS Leong, FT Chong, PH Sew, DP Lau, BH Wong, BT Teh, DSW Tan, NG Iyer. Targeting cancer stem cell plasticity through modulation of Epidermal growth factor and Insulin-like growth factor receptor signaling in head and neck squamous cell cancer.  Stem Cell Trans Med 2014 Jul 14;3:1-11.

 

·         C Chia, XJ Li, CN Qian, BT Teh, KC Soo, HK Tan, NG Iyer. Serglycin expression: an independent marker of distant metastases in nasopharyngeal carcinoma. Head Neck 2014 Jul 3;36(8)

 

·         JC Ng, W Wang, MJ Chua, MS Tan, NC Tan, KC Soo, HK Tan, NG Iyer. Subcutaneous injection is a simple and reproducible option to restore parathyroid function after total parathyroidectomy in patients with secondary hyperparathyroidism. Surgery 2014 Apr;155(4):682-8.

 

·         DS Tan, S Camilleri-Broët, EH Tan, M Alifano, WT Lim, A Bobbio, S Zhang, QS Ng, MK Ang, NG Iyer, A Takano, KH Lim, JF Régnard, P Tan, P Broët. Intertumour heterogeneity of non-small cell lung carcinomas revealed by multiplexed mutation profiling and integrative genomics. Int J Cancer. 2014 Sep 1;135(5):1092-100.

 

·         B Tian, D Khoo, AC Tay, KC Soo, NC Tan, HK Tan, NG Iyer. Management of oro-cutaneous fistulas using a vacuum-assisted closure system. Head Neck 2014 Jun;36(6):873-81.

 

·         AS Ho, K Kannan, DM Roy, LG Morris, I Ganly, N Katabi, D Ramaswami, LA Walsh, S Eng, JT Huse, J Zhang, I Dolgalev, K Huberman, A Heguy, A Viale, M Drobnjak, MA Leversha, CE Rice, B Singh, NG Iyer, CR Leemans, E Bloemena, RL Ferris, RR Seethala, BE Gross, Y Liang, R Sinha, L Peng, BJ Raphael, S Turcan, Y Gong, N Schultz, S Kim, S Chiosea, JP Shah, C Sander, W Lee, TA Chan.  The mutational landscape of adenoid cystic carcinoma. Nat Genet. 2013 Jul;45(7):791-8.

 

·         MS Yeang, K Tay, WS Ong, TC Ha, A Thiagarajan, DSW Tan, PTH Teo, KC Soo, HK Tan, NG Iyer. Post-Irradiation Sarcomas of the Head and Neck: a case-control study of outcomes and prognostic factors in a tertiary institution. Ann Surg Oncol. 2013 Sep;20(9):3066-75.

 

·         G Tay, KC Soo, A Thiagarajan, HK Tan, NG Iyer. Squamous cell carcinoma of the ear arising in patients after radiotherapy for nasopharyngeal carcinoma.  Eur Arch Otolaryngol. 2014 Jan;271(1):149-56.

·         W Tan, C Chia, KC Soo, HK Tan, NG Iyer. Depth of invasion is an important prognostic factor in squamous cell carcinoma of the anterior tongue. ORL J Otorhinolaryngol Relat Spec 2012;74(5):264-70.

 

·         NG Iyer, L Kim, IJ Nixon, F Palmer, JP Shah, SG Patel, I Ganly. Outcome of patients with early T1 and T2 squamous cell carcinoma of the base of tongue managed by conventional surgery with adjuvant postoperative radiation. Head Neck 2013 Jul;35(7):999-1006.

 

·         NG Iyer, IJ Nixon, F Palmer, L Kim, M. Whitcher, Katabi N, Ghossein R, JP Shah, SG Patel, I Ganly. Surgical management of squamous cell carcinoma of the soft palate: Factors predictive of outcome. Head Neck. 2012 Aug;34(8):1071-80.

 

·         A Thiagarajan, N Caria, H Schoder, NG Iyer, RJ Wong, D Kraus, S Wolden, N Lee. Target volume delineation in oropharyngeal cancer: Impact of PET, MRI and physical examination. Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):220-7.

 

·         NG Iyer, LG Morris, RM Tuttle, AR Shaha, I Ganly. Rising incidence of second cancers in low-risk (T1N0) thyroid cancer patients receiving radioactive iodine therapy. Cancer. 2011 Oct 1;117(19):4439-46.

 

·         T Chua, NG Iyer, KC Soo. Prolonged Survival Following Maximal Cytoreductive Effort for Peritoneal Metastases from Recurrent Granulosa Cell Tumor. J Gynecol Oncol.  2011 Sep;22(3):214-7.

 

·         NG Iyer, A Kumar, I Nixon, F Palmer, M Whitcher, SG Patel, RM Tuttle, AR Shaha. Incidence and Significance of Delphian node metastasis in papillary thyroid cancer. Ann Surg. 2011 May;253(5):988-91

 

·         XJ Li , CK Ong, Y Cao, Y Xiang, JY Shao, A Ooi, LX Peng, WH Lu, Z Zhang, D Petillo, L Qin, YN Bao, FJ Zheng, CS Chia, NG Iyer, TB Kang, YX Zeng, KC Soo, JM Trent, BT The, CN Qian. Serglycin is a theranostic target in nasopharyngeal carcinoma that promotes metastasis. Cancer Res. 2011. Apr;71: 3162-3172

 

·         NG Iyer, AR Shaha. Central compartment dissecion in well—differentiated thyroid cancer… and the band played on. Current Opinion in Otolaryngology & Head & Neck Surgery. 2011 Apr;19(2):106-12.

 

·         NG Iyer, IJ Nixon, F Palmer, I Ganly, SG Patel, AR Shaha. Electronic synoptic operative reporting for thyroid surgery using and electronic data management system: potential for prospective multi-center data collection. Ann Surg Oncol. 2011 Mar;18(3):762-6.

 

·         GS Mannu, NG Iyer, JP Shah. Frontal sinus cancer resection and reconstruction. JRSM Short Rep. 2011 January; 2(1): 2

 

·         NG Iyer, L Kim, IJ Nixon, F Palmer, D Kraus, AR Shaha, JP Shah, SG Patel, I Ganly. Factors Predicting Outcome in Malignant Minor Salivary Gland Tumors of the Oropharynx. Arch Otolaryngol Head Neck Surg 2010 Dec;136(12):1240-7

 

 

·         H Hornbeek, NG Iyer, DL Carlson, HE Stambuk, M Ryder, I Ganly. Functional Vagal Paraganglioma: A Case Report Illustrating Diagnosis and Management. Skull Base 2010; 20(6): 491-496.

 

·         NG Iyer, S Singham, J Zhu, JR Clark. Role of pre-treatment PET/CT in surgical decision making of head and neck cancers. Head Neck. 2010 Sep;32(9):1202-8.

 

·         NG Iyer, AR Shaha, A Ferlito, K Thomas Robbins, JE Medina, CE Silver, A Rinaldo, RP Takes, C Suárez, JP Rodrigo, PJ Bradley, JA Werner. Delphian node in head and neck cancers: oracle or myth. J Surg Oncol. 2010 Sep 15;102(4):354-8.

 

·         NG Iyer, AR Shaha. Management of thyroid nodule and surgery for differentiated thyroid cancer. Clin Oncol (R Coll Radiol). 2010 Aug;22(6):405-12.

 

·         NG Iyer, AR Shaha, CE Silver, KO Devaney, A Rinaldo, PK Pellitteri, A Ferlito. Thyroid incidentalomas- to treat or not to treat. Eur Arch Otoloaryngol. 2010 Jul;267(7):1019-26.

 

·         NG Iyer, AR Shaha. Complications of thyroid surgery- prevention and management. Minerva Chir. 2010 Feb;65(1):71-82

 

·         NG Iyer, AR Shaha. Current concepts in managing primary hyperparathyroidism. Indian J Surg Oncol. 2010 Feb; 1(2):112-119

 

·         NG Iyer, AR Shaha. Controversies and challenges in the management of well-differentiated thyroid cancers. Indian J Surg. 2009 Dec ; 71(6):299-307

 

·         NG Iyer, JR Clark, BG Ashford. Internal mammary artery perforator flap for head and neck reconstruction. ANZ J Surg. 2009 Nov; 79(11): 799-803.

 

·         NG Iyer, JR Clark, R Murali, K Gao, CJ O’Brien. Outcomes following parotidectomy for metastatic squamous cell carcinoma with microscopic residual disease: Implications for facial nerve preservation. Head Neck. 2009 Jan;31(1):21-7.

 

·         AA Ahmed, AD Mills, AE Ibrahim, J Temple, C Blenkiron, M Vias, CE Massie, NG Iyer, A McGeoch, R Crawford, B Nicke, J Downward, C Swanton, SD Bell, HM Earl, RA Laskey, C Caldas, JD Brenton. The Extracellular Matrix Protein TGFBI Induces Microtubule Stabilization and Sensitizes Ovarian Cancers to Paclitaxel. Cancer Cell. 2007 Dec 6;12(6):514-527.

 

·         Y Zhao, MS Hamza, HS Leong, CB Lim, YF Pan, E Cheung, KC Soo, NG Iyer. Kruppel-like factor 5 modulates p53-independent apoptosis through Pim1 survival kinase in cancer cells. Oncogene. 2008 Jan 3;27(1):1-8. Epub 2007 Jul 2. (Principal Investigator)

 

·         SF Chin, Y Wang, N Thorne, A Teschendorff, S Pinder, M Vias, A Naderi, I Roberts, N Barbosa-Morais, M Garcia, NG Iyer, T Kranjac, J Robertson, S Aparicio, S Tavare, I Ellis, JD Brenton, C Caldas. Using array-comparative genomic hybridizations to define molecular portraits of primary breast cancers. Oncogene. 2007 Mar 22;26(13):1959-70.

·         NG Iyer, SF Chin, Y Daigo, A Bannister, H. Ozdag, T Kouzarides, S Aparicio, C Caldas. p300 is required for orderly G1/S transition in human cancer cells. Oncogene. 2007 Jan 4;26(1):21-9.

 

·         JG Bundy, NG Iyer, M Gentile, DE Hu, Kettunen M, AT Maia, C Caldas, KM Brindle. Metabolic consequences of p300 gene deletion in human colon cancer cells. Cancer Res. 2006 Aug 1;66(15):7606-14. (Co-first author)

 

·         D Krubasik, NG Iyer, WR English, AA Ahmed, M Vias, C Roskelley, JD Brenton, C Caldas, G Murphy. Absence of p300 induces cellular phenotypic changes characteristic of epithelial to mesenchyme transition. Br J Cancer. 2006 May 8;94(9):1326-32. (Co-first author)

 

·         J Tan, L Zhuang, HS Leong, NG Iyer, ET Liu, Q Yu. Pharmacologic modulation of glycogen synthase kinase-3beta promotes p53-dependent apoptosis through a direct Bax-mediated mitochondrial pathway in colorectal cancer cells. Cancer Res. 2005 Oct 1;65(19):9012-20

 

·         MF Fraga, E Ballestar, A Villar-Garea, M Boix-Chornet, J Espada, G Schotta, T Bonaldi, C Haydon, S Ropero, K Petrie, NG Iyer, A Perez-Rosado, E Calvo, JA Lopez, A Cano, MJ Calasanz, D Colomer, MA Piris, N Ahn, A Imhof, C Caldas, T Jenuwein, M Esteller. Loss of acetylation at Lys16 and trimethylation at Lys20 of histone H4 is a common hallmark of human cancer. Nat Genet. 2005 Apr;37(4):391-400.

 

·         HE Huang, SF Chin , C Ginestier, VJ Bardou, J Adelaide, NG Iyer, MJ Garcia, JC Pole, GM Callagy, SM Hewitt, WJ Gullick, J Jacquemier, C Caldas, M Chaffanet, D Birnbaum, PA Edwards. A recurrent chromosome breakpoint in breast cancer at the NRG1/neuregulin 1/heregulin gene. Cancer Res. 2004 Oct 1;64(19):6840-4

 

·         NG Iyer, SF Chin, H. Ozdag, Y Daigo, DE Hu, M Cariati, K Brindle, S Aparicio C Caldas. p300 regulates p53-dependent apoptosis after DNA damage in colorectal cancer cells by modulation of PUMA/p21 levels. Proc Natl Acad Sci U S A. 2004 May 11;101(19):7386-91.

 

·         AA Ahmed, M Vias, NG Iyer, C Caldas, JD Brenton. Microarray segmentation methods significantly influence data precision. Nucleic Acids Res. 2004 Mar 17;32(5):e50.

 

·         NG Iyer, H Ozdag, C Caldas. p300/CBP and cancer . Oncogene. 2004 May 24;23(24):4225-31.

 

·         NG Iyer, Carlos Caldas. Gastric Cancer — Keeping It in the Family. Cancer Reviews: Asia-Pacific. 2004 Jul; 2(1): 69-79

 

·         SF Chin, Y Daigo, H Huang, NG Iyer, T Kranjac, G Callagy, M Gonzalez, T Sangan, H Earl, C Caldas. A simple and reliable pre-treatment protocol facilitates fluorescent in-situ hybridisation (FISH) on tissue microarrays (TMAs) of paraffin embedded tumour samples. Mol Pathol. 2003 Oct;56(5):275-9

 

 

·         H Ozdag, S Batley, A Fosti, NG Iyer, Y Daigo, M Arends, BAJ Ponder, T Kouzarides, and C Caldas. Mutation analysis of CBP and PCAF reveals rare inactivating mutations in cancer cell lines but not in primary tumours. Br J Cancer 2002 Nov 4;87(10):1162-5


Manuscripts in Preparation

 

·         C Chia, XJ Li, CN Qian, BT Teh, KC Soo, HK Tan, NG Iyer. Overexpression of CALB1 correlates with a metastatic phenotype in nasopharyngeal carcinoma

 

·         G Tay, WS Ong, TC Ha, J The, D Tan, NG Iyer, HK Tan. Post-irradiation squamous cell carcinomas of the head and neck in patients with prior nasopharyngeal carcinoma.

 

·         VKM Tan, R Sivanandan, JS Hwang, WS Ong, TC Ha, SY Lee, KC Soo, HK Tan, NG Iyer. Increased expression of CD44 is associated with better outcome in squamous cell carcinoma of the tongue.

Publications (Book Chapters)

·         NG Iyer, AR Shaha. Surgical Management of Loco-regional Recurrence in Thyroid Cancer (Book chapter). Thyroid surgery. (Ed Isgor) (Submitted)

 

·         NG Iyer, AR Shaha. Reoperative thyroid surgery (Book chapter). Thyroid Surgery: Preventing and Managing Complications. (Eds P Miccoli, DJ Terris, M Minuto, MW Seybt). Jan 2013. Wiley-Blackwell Publication

 

·         NG Iyer, AR Shaha. Recurrent thyroid cancer. (Book chapter) Head and neck cancer recurrence- evidence-based, multidisciplinary management. (Eds H Mehanna, K Ang) 2012. Thieme Medical Publishing

 

·         NG Iyer, AR Shaha. Management of the neck in papillary thyroid cancer. (Book chapter/ Spanish) Papillary thyroid cancer. (Eds L Kowalski, J Novelli) (In press)

 

·         NG Iyer, AR Shaha. Tracheal resection for locally advanced thyroid cancers. (Book chapter) Atlas of Otolaryngology Head and Neck Surgery (Eds Z Gil, D Fliss) (In press)

 

·         NG Iyer, AR Shaha. Locally invasive thyroid cancer. (Book chapter)  Journal of ENT Masterclass 2010. Dec 2010. 3(1): 112-117 (Eds MS Quraishi, P Bradley)

 

·         NG Iyer, RJ Wong. Local and regional recurrence in head and neck squamous cell carcinoma. American Academy of Otolaryngology AcademyU online course. Published online, March 2010

 

·         NG Iyer, AR Shaha. Management of thyroid lymphomas, metastatic lesions and other rare tumors. (Book chapter). Handbook of Endocrine Surgery (Eds R Sippel, H Chen). Sept 2011. World Scientific Books

 

·         NG Iyer. Functional characterisation of p300. PhD thesis submitted to University of Cambridge. 2003 Feb.

 

Research Projects

Basic science:

·         Biology of head and neck cancer stem cells: response to DNA damage, drug resistance and plasticity

Translational research:

·         Molecular profiling and genomic sequencing of young tongue cancers, recurrent oral cancer

 

·         Modulation of tyrosine kinase inhibitor response in head and neck cancers

 

·         Prognostic biomarkers in head and neck and nasopharyngeal cancers

 

·         Novel drug targets and pathways in head and neck cancer

 

·         Mouse carcinogenesis model in tongue cancers

Clinical research:

·            Trial co-ordinator (translational research) for multi-centre phase III trial comparing efficacy of chemoRT versus chemoRT plus nimotuximab in post-operative patients with high-risk head and neck cancers IHN01 trial)

 

·            Radiation induced cancers after treatment for nasopharyngeal carcinoma

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