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Vol 21, No. 08, August 2017   |   Issue PDF view/purchase
Precision Medicine for Cancer Patients: Interview with Dr Allen Lai

APBN is honoured to interview Dr Allen Lai on how genetic testing aids in personalized treatment and care for cancer patients. From the interview, we get to learn more about ACT Genomics where Dr Allen is the Senior Vice President. ACT Genomics is a biotech company focused in cutting-edge genomic profiling and empowering physicians and patients with evidence-based information. Its headquarters is based in Taiwan with offices located in Singapore, Hong Kong, Shanghai and Tokyo. ACT Genomics envisions to rewrite the existing model of cancer diagnostics, cancer treatment and cancer monitoring, through genetic testing and analysis for cancer prevention and manageability.

About the Interviewee

Allen Lai, MD, MSc, MPA, PhD

Allen Lai is the Senior Vice President of ACT Genomics, strategizing corporate development, planning and execution of cancer genomics clinical & research projects in South East Asia. He holds high-profile roles such as Advisor Board of ISPOR Asia Consortium, President of ISPOR Singapore and concurrently Senior Consultant, Ministry of Health and Social Welfare, Taiwan. Dr Lai previously was principal consultant at IMS Health Asia, director of the Institute of Health Economics & Management and academic director of MSc Management of Health Industries in ESSEC Business School. He received his PhD and MPA from Lee Kuan Yew School of Public Policy, National University of Singapore, MSc (Preventive Medicine) from National Taiwan University and MD from Chung Shan Medical Dental University, Taiwan.

1. ACT Genomics performs comprehensive tumour genetic testing so that patients with a wide variety of cancer types can find a suitable targeted treatment. What technology is used by ACT Genomics?

We deploy a high throughput method called next-generation sequencing (NGS) to effectively profile solid tumours retrieved from cancer patients. With our in-house proprietary pipeline in bioinformatics and modified protocols from sample processing to genomics report generation, we can customize personalized treatment options matched for each individual patient along the continuum of cancer care.

2. ACT Genomics has established a state-of-the-art next generation sequencing (NGS) platform. Could you briefly explain what is NGS and its functions/advantages?

Basically, NGS is a method that generates massive sequencing data in a single test run with minimal sample required. Within a short turnaround time, this method allows a rapid and comprehensive gene analysis that meets the requirements of clinical settings. Through bioinformatics data processing and utilizing clinical databases, gene mutations are matched with the appropriate targeted therapies to provide patients and doctors with personalized treatment options.

3. Will you see the accuracy and speed of genetic testing as a challenge? Will it be able to tell different cancer types apart?

To gain technical accuracy (e.g., test reproducibility) is not an issue for molecular laboratories certified by internationally accredited body such as CAP (College of American Pathologists) whereas clinical accuracy (precision) relies on the method of DNA enrichment and how genetic mutation is identified and interpreted as a driving force of oncogenesis. The speed of genetic testing, i.e. turnaround time (TAT), is not a challenge for experienced genomic profiling service providers whose workflow is streamlined with multiple checkpoints of quality control. It is now well accepted among oncologists for TAT to be within 14 calendar days in most targeted sequencing panels.

4. From your point of view, how do you think people can prevent cancer from developing even if it is inherited? Are hereditary cancers more common than environmentally-induced cancers? How do we reduce the risk of getting cancer in general?

Cancer is caused by a damage to our DNA, what we inherited are genetic variants that may increase our risk of getting cancer. A good lifestyle like not smoking, keeping active, a healthy balanced diet and a healthy bodyweight surely could help to reduce the risk of cancer development. If you have a strong family history of cancer or were found to carry an inherited deleterious mutation, talk to your GP or genetic counsellor, who may suggest prevention strategies or treatment to try to reduce the risk.

5. Do you think medical big data and innovative technology play a vital part in providing precision medicine for cancer patients?

I’ve no doubt that big data cum innovative tech will be a game changer in transforming how healthcare is managed. This is also very true in precision medicine when we stratify the right subgroup of cancer patients in accordance with their molecular profile. However we need to be mindful the quality (structure, hierarchy, level, and scope) of the data matters to what eventually turns out. To make big data more powerful in prediction as well as prescription, the data involved, and further being analysed, need to be curated and aggregated in a more structured fashion so that when applying to clinical dilemmas, we can turn the intelligence into action, not just for the sake of collecting tons of information.

6. Medical institutions and hospitals equipped with more medical innovations and technology, do you think patient access to healthcare indeed has improved in the last few years?

In both the urban or suburban settings, I believe patient access to healthcare has improved over the years, especially with applications in smart mobile devices such as portable medical devices capable to transmit vital information to central data warehouse managed by healthcare organizations. However, to diagnose what may seem wrong is one thing, to treat and manage properly the illness is another. Increasing access to healthcare is merely part of mandate of health for all. It shall not be equal to improvement of health outcomes.

7. During the panel discussion at FT Asia Healthcare & Life Sciences Summit, you mentioned that the healthcare system can be improved by standardization. Could you please elaborate?

The standardisation of data from clinical services is required so that it can be more easily cross-referenced with patient medical records. The National Electronic Health Records (NEHR) system can evaluate the interventions by measuring the outcomes such as quality of care, mobility and mortality, overall survival, utilization of facilities, delivery effectiveness, coverage of vaccination, etc.

8. Are there any impactful cancer genomics clinical and research project in the region?

Yes, the Targeted Agent and Profiling Utilization (TAPUR) Study, initiated by the American Society of Clinical Oncology, Inc. (ASCO), has extended its research sites to two major countries in Asia, Japan and Singapore. The project is a non-randomized clinical trial that aims to describe the performance (both safety and efficacy) of commercially available, targeted anticancer drugs prescribed for treatment of patients with advanced cancer that has a potentially actionable genomic variant. The TAPUR Study provides approved targeted therapies that are contributed to the program by collaborating pharmaceutical companies, catalogues the choice of genomic profiling test by clinical oncologists and aims to learn about the utility of registry data to develop hypotheses for additional clinical trials. ACT Genomics is now in the discussion with one research site as the genomics sequencing partner.

9. Other than tailoring treatment options to help cancer patients, does ACT Genomics focus on research, too? What other technologies do you utilize in your company?

Yes, we do. Though the fast-growing of big-data and technologies, the knowledge of cancer biology, pharmacogenomics, etc., are still limited. We do have research collaborations with pharma, clinicians, researchers, trying to accumulate information for future drug and healthcare development.

10. Besides being the Regional Managing Director of ACT Genomics Singapore, what are your roles and responsibilities as the President for ISPOR (International Society for Pharmacoeconomics & Outcome research)?

I have led ISPOR-Singapore to conduct fundamental research in health economics and capability-building educational activities directed towards the promotion of pharmacoeconomics and outcomes research in Singapore. In this capacity, we are able to facilitate scholarly and engaging discussion on far-reaching topics, such as personalized medicine and stakeholder management in health technologies, among researchers, biopharmaceutical companies, healthcare practitioners, and decision-makers.

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