New made-in-Singapore cancer drug could lower leukaemia mortality

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A new cancer drug promises to take a more targeted approach to treating leukaemia and other forms of blood cancer, researchers told Channel NewsAsia on Thursday (Mar 9).

As such, the drug, known as ETC-206, could lower leukaemia mortality rates compared to traditional chemotherapy, which attacks the immune system as much as it kills cancer cells.

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Researchers added that the drug could also be used to reduce or eliminate the potential side effects of other cancer treatments, when used together.

The made-in-Singapore drug is developed by Duke-National University of Singapore Medical School (Duke-NUS) and the Agency for Science, Technology and Research’s (A*STAR) Drug Discovery and Development unit (D3) and Experimental Therapeutics Centre (ETC).

LIKE “STOPPING A CAR THAT’S GOING OUT OF CONTROL”

The drug specifically inhibits what is known as the Mnk enzyme in cancer cells – a part of the cell identified with promoting growth – effectively stopping the spread and progression of the disease.

It was a Duke-NUS team which first identified the Mnk enzyme as a promising target to attack.

Duke-NUS Associate Professor Ong Sin Tiong likened cancer cells to cars speeding out of control and in danger of crashing. “As you can imagine, there are many ways of stopping a car that’s going out of control,” he said.

“What we’ve discovered is one specific way of stopping this car – so for example, taking the spark plugs out.

So this drug that we’ve developed with ETC specifically hits this … so that the car will come to a stop.”

The drug took a team of chemists about 60 weeks to synthesise manually. They sifted through over 2,000 compounds in 700 possible combinations to find a formula that met their criteria for potency, chemical stability and purity, among others.

The drug has been undergoing its first phase of clinical trials on 34 healthy volunteers.

Results to date show that the drug is well-tolerated by the human body when taken orally, said Professor Alex Matter, CEO of ETC and D3.

Further information from this trial will help researchers gauge the safety and effectiveness of the drug on the human body.

This will inform a second trial – or Phase 1b – on later-stage leukaemia patients, which is slated for August.

“If all goes well, in the higher doses we should see some clinical readouts such as a decrease in leukaemic cells. That would be fabulous, and that would encourage us to declare a proof of concept – in principle – to go forward into a Phase 2,” said Prof Matter.

Phase 2 entails testing for the appropriate dose of the drug on a larger patient group.

“We would still need a larger trial – the so-called pivotal trials, to convince health authorities that yes, there’s definite proof that this drug is safe and efficacious. Once we have this definite proof in Phase 3, we can request an approval from the authorities, and then we can think of launching this drug candidate on the market,” said Prof Matter.

The process from discovering a drug target to the proof-of-concept stage could take as long as six years.

Researchers said their method of Mnk-inhibition is “a final common path for many human malignancies”, and could also translate to the treatment of some other cancers.

ETC-206 is the second publicly funded cancer drug developed in Singapore after ETC-159, which was announced in 2015. The first drug targets a wider range of cancers, including colorectal, ovarian and pancreatic cancer.

Cancer remains the top cause of death in Singapore, and is responsible for almost 30 per cent of all deaths in Singapore in 2015, according to the Health Ministry.

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