A collaboration between National Cancer Center Singapore (NCCS) and Clearbridge BioMedics, in partnership with the pathology department at Singapore General Hospital (SGH), has resulted in the establishment of the region's first Circulating Tumor Cell Center of Research Excellence (CTC CoRE). This new center facilitates the use of circulating tumor cells (CTCs) in clinical diagnostics, in order for new technologies to be applied by healthcare institutions.

The CTC CoRE is a key enabler in Singapore's efforts to advance the development of personalized medicine, which is the customized healthcare of an individual patient. The research at the CTC CoRE aims to understand the genetic makeup of a patient's cancer cells, which can evolve over time.

To determine the effectiveness of treatment, blood samples will be drawn from the patient pre- and post-treatment. The blood samples are sent to the Cytology Lab at SGH and put through the ClearCell FX system to separate the cancer cells from other blood components. Using a cytogenetic test, the number of cancer cells are counted and documented. If there is no significant reduction in the number of cancer cells, the oncologist may decide to modify the treatment regime to best combat the cancer. Not only does this result in a dramatic effectiveness in cancer therapy management, it also leads to reduced side effects and significant cost savings.

The CTC CoRE is located at the newly-opened academia, within SGH's pathology department. This allows researchers at the CTC CoRE to have access to the cytology, immunohistochemistry, cytogenetics and molecular capabilities.

The CTC CoRE will focus on a number of research programs and clinical trials at NCCS and SGH, with support from Clearbridge BioMedics, including pilot use of the ClearCell FX system, Clearbridge BioMedics' novel label-free enrichment system for CTCs, first invented at the National University of Singapore. The CTC CoRE also will be developing novel CTC diagnostic assays for personalized medicine that will enable clinicians to tailor therapies to individual patients' unique genetic makeup. It is envisioned that these diagnostic assays will eventually be adopted as part of routine clinical service, enabling clinicians to obtain real-time feedback on therapeutic effectiveness, in order to improve cancer management and patient outcomes.

"With the establishment of this CTC CoRE, Clearbridge BioMedics now is entering the clinical diagnostics field. We are delighted to work with a leading cancer center in Singapore, to validate the clinical utility of our ClearCell FX system, which we target to be in the clinic by 2015. The ultimate aim is for the CTC CoRE to allow cancer clinicians to access technologies that reliably process and analyze patients' blood, for actionable clinical results," said Johnson Chen, director, Clearbridge BioMedics.

"Circulating tumor cells have the potential to become a powerful tool in how oncologists diagnose, treat and manage cancers. Setting up this CTC CoRE facility will allow our researchers to characterize these cells real-time, even as a patient's tumor evolves due to treatment and time. This will boost NCCS's position as a center for cancer management, as well as enhance Singapore's reputation as an oncology thought leader in Asia," said professor Soo Khee Chee, director, National Cancer Center Singapore.

"Pathology represents the final bridge between basic science and clinical medicine. The pathology department at SGH is able to work as an incubator for biomedical care, research and innovation. By understanding the genetic make-up of a patient's cancer cells, personalizing cancer treatment can be achieved. This collaboration will enable us to leverage on each other's experience and explore new technologies to improve patient care and outcomes," said associate professor Tan Puay Hoon, head, department of pathology, Singapore General Hospital.