By Liaw Wy-Cin

THE National Cancer Centre of Singapore (NCCS) is embarking on one of its most ambitious drug trials yet.

It is coordinating a trial for an experimental drug for head and neck cancers involving 700 patients from 22 institutions in 12 countries.

NCCS is working with Innogene Kalbiotech, a Singapore company commercialising the drug, to conduct the trial which begins in March. It will test how effective this new drug called nimotuzumab is, when used with the standard treatment for the diseases.

Head and neck cancers are among the top 10 cancers in Singapore, with some 200 new cases every year. Without treatment, patients die within a year. Of those who receive the standard treatment of surgery, chemotherapy and radiation, half of them do not live for more than five years.

NCCS director Soo Khee Chee is hoping to improve this number to 60 per cent, by adding the use of this drug to the standard treatment.

Patients will have free access to the drug during the trial which will last three to five years, said Professor Soo.

A new drug is usually tested on humans in three phases before it can be approved for use. These tests are known as clinical trials.

In the NCCS-led trial, nimotuzumab will be tested in a Phase III clinical trial for head and neck cancers here. Of the 700 patients, 20 to 40 a year will be recruited in Singapore.

In a Phase II study done in India, combining the drug with chemotherapy and radiation improved survival at 15 months from 70 per cent to 95 per cent.

Prof Soo said it took four years to court the various participating institutions to take part in this trial.

The network created among countries, including India, Japan, South Korea and Israel, means greater clout on the drug development scene.

'When you have this network, pharmaceutical companies will be interested in you,' he said.

They have the deep pockets needed to fund expensive clinical trials. Being part of this network also means the potential for other research for NCCS, in terms of collaboration, training and access to data, said Prof Soo.

Currently, there is only one other drug approved to treat head and neck cancers - cetuximab.

The experimental drug on trial is expected to have fewer side effects than cetuximab, according to Innogene. Its director, Dr Rikrik Ilyas, said it is supposed to target a cancer cell more specifically than cetuximab, which also targets cells found on the skin.

Innogene is providing the drug free of charge for the trial.

Nimotuzumab was discovered by scientists at Cuba's Centre of Molecular Immunology.

While it has not been approved for use here yet, some doctors in Singapore have been granted special approval for use on brain tumour patients.

The NCCS-led trial will cost $5 million in total.

This article was first published in The Straits Times on Jan 3, 2009.