Screen for stomach cancer with a blood test

Non-invasive test developed by A*Star spin-off may be rolled out as soon as next year
By Carolyn Khew, The Straits Times, 12 Feb 2016

A blood test to assess early-stage stomach cancer, a major killer here, could be rolled out in local hospitals as soon as next year.

Instead of going for an uncomfortable endoscopy to see if they are at risk, patients can first take the blood test to see whether more detailed tests are needed.

The diagnostic kit is the brainchild of MiRXES - a spin-off by researchers from the Agency for Science, Technology and Research (A*Star). With just a few drops of blood, doctors are able to detect accurately whether a patient has developed early-stage gastric cancer.

The kit detects the patterns of microRNA - a type of gene - in a blood sample and the results can be obtained in as little as three hours.

"Screening and early detection help save lives but the issue with the existing screening methods is that they are extremely invasive and costly," said MiRXES co-founder Zhou Lihan.

"Because of endoscopy being an invasive procedure, there will be some people who refuse to do it."

According to the National Cancer Centre Singapore, stomach cancer is among the top 10 cancers in Singapore. In Asia, it affects more than 700,000 people each year. Early detection is key to improving patient outcomes but early-stage stomach cancer rarely causes any symptoms.

Current methods used to detect the cancer are endoscopy and biopsy, which involve passing a scope through the mouth into the stomach to collect samples of possibly cancerous ulcers or bumps.

The kit, which was first developed last year, would also help to cut costs. According to clinical data, it is estimated that only one in about 170 patients who undergo endoscopy actually have gastric cancer, said Dr Zhou.

According to the Ministry of Health's website, an endoscopy costs around $300 to $900 with medical subsidy.

Co-developed with the Singapore Gastric Cancer Consortium - which is led by Professor Yeoh Khay Guan, a gastroenterologist - the kit is undergoing clinical validation with 7,000 patients. Upon regulatory approval, the test will be launched in local hospitals.

The technology is also being used for research by top universities and research institutes globally, including Georgetown University in the United States.

Dr Martin Brand, a clinical scientist from the University of the Witwatersrand department of surgery, said he is working with MiRXES to develop a kit that can detect pancreatic cancer and monitor patient response.

"Currently we are identifying which microRNA are important in pancreas cancer patients. Once we have this done, MiRXES will develop a kit that we can use in a prospective study," said Dr Brand.

MiRXES co-founder Too Heng- Phon, who is from A*Star and is also an associate professor at the National University of Singapore's biochemistry department, said it was not a bed of roses when they were starting out.

Investors were cautious and some scientists in the international community were sceptical about using microRNA to detect cancer.

"It was tough and there were people who were sceptical but we believed in what we did," said Dr Too.

"Start-ups are not something that scientists here look at but where I studied over at Cambridge, Harvard and the MIT, it's a very common thing to do. So we thought why not set an example?"