Singapore, 16 July 2025 – In a national effort to transform lung cancer care, the National Cancer Centre Singapore (NCCS), in collaboration with the Agency for Science, Technology and Research (A*STAR) and National University Cancer Institute, Singapore (NCIS), has been awarded a S$25 million grant by the Singapore Ministry of Health through the National Medical Research Council (NMRC) Office, MOH Holdings Pte Ltd, under the NMRC Open Fund-Large Collaborative Grant (OF-LCG) programme.
The grant establishes Conquering Lung cancer Across all stages with Research and InnovatiON (CLARION), a research programme that brings together a multidisciplinary team of experts in medicine, genomics, and translational and data science to improve outcomes for lung cancer through studying methods for early detection, personalised treatment, and gaining a deeper understanding of why the disease behaves differently in Asian patients.
The urgent need to improve lung cancer outcomes
Lung cancer is the deadliest cancer globally, and in Singapore, three people die from the disease each day1. Most cases are detected only after the cancer has spread, making it much harder to treat. Unlike the West, where most lung cancer cases are linked to smoking, nearly half of lung cancer patients in Singapore have never smoked2. Many of these patients are diagnosed with a form of lung cancer called non-small cell lung cancer (NSCLC), which is often driven by genetic mutations in a gene known as EGFR.
In the past two decades, the advent of targeted therapies, like EGFR-tyrosine kinase inhibitors (TKIs) osimertinib, have greatly improved survival. However, most patients develop drug resistance within 9 to 15 months, leading to cancer recurrence. Even patients with early-stage disease who undergo surgery are at risk of relapse. The reasons behind drug resistance remain poorly understood. Adding to the challenge, many clinical trials for lung cancers are conducted in Western populations, with results having limited applicability for Asian patients. In Asia, limited trial access and gaps in knowledge about which patients are most likely to benefit from targeted treatments mean that promising new therapies can take years to reach those who need them.
Collectively, these factors highlight the critical need to understand the disease biology of Asian lung cancer to improve and accelerate the delivery of cost-effective therapies, design innovative clinical trials to combat treatment resistance, and stratify patients to receive the most appropriate treatments.
CLARION is a continuation of over 10 years of research done by the group – under the NMRC Translational and Clinical Research (TCR) Flagship programme (S$10 million awarded in 2013) and the Next-Generation Clinical Trials and Integrative Research for Fighting Lung Cancer OF-LCG programme (S$10 million support from the NMRC in 2019) – which established Singapore’s leadership in Asian lung cancer research.
Earlier key outcomes include:
Building on the foundations of their earlier discoveries and effort, the multidisciplinary CLARION team of clinicians and scientists from NCCS, NCIS, A*STAR Genome Institute of Singapore (A*STAR GIS) and A*STAR Institute of Molecular and Cell Biology (A*STAR IMCB) will conduct research and clinical trials focused on Asian lung cancer to improve outcomes across the entire lung cancer care continuum. The team now also includes A*STAR Institute of High Performance Computing (A*STAR IHPC).
The CLARION research programme will focus on 5 thematic areas to achieve its goals:
CLARION Corresponding Principal Investigator Professor Daniel Tan, Senior Consultant at the Department of Lung, Head & Neck and Genitourinary Medical Oncology, Division of Medical Oncology, and Head of the Division of Clinical Trials and Epidemiological Sciences, NCCS said, “We are grateful for the grant funding support which allows us to push the boundaries of research to improve lung cancer care for Asian patients. Our earlier studies clearly indicated that a one-size-fits-all approach does not work. Our mission with CLARION is to predict, prevent and personalise care at every stage of the disease—from early detection to advanced treatment—so that patients diagnosed with lung cancer in Asia can live longer and live well.”
Associate Professor Tam Wai Leong, CLARION Theme 4 Co-Lead and Deputy Executive Director at A*STAR GIS said, “Lung cancer cells eventually develop mechanisms to evade targeted therapies. These drug persister cells, also known as cancer stem cell cells, form the basis for cancer relapse. Our studies will now begin to interrogate genetic pathways that give rise to these recalcitrant cells, with the goal of uncovering new vulnerabilities that can be targeted therapeutically. The deep collaboration between clinicians and biomedical scientists that is enabled by CLARION will accelerate clinical translation and move us closer to precision oncology for lung cancer patients in Singapore.”
Dr Tee Wee Wei, CLARION Theme 4 Co-Lead and Senior Principal Scientist at A*STAR IMCB said, “Patients often face relapse because current treatments cannot fully eliminate drug-resistant cells. By understanding the biology of these persister cells, we hope to develop therapies that can target and remove them before they take hold. This could shift the treatment goal from simply managing lung cancer to preventing its return — offering patients a more durable and potentially curative outcome.”
Dr Huang Yiqing, CLARION Theme 1 Co-Lead and Consultant, Department of Haematology-Oncology, NCIS said, “Our past work has given us unique insights into lung cancer in the Asian population. Through the five thematic areas in our upcoming programme, we hope to focus on critical challenges such as unravelling resistance mechanisms of targeted therapies in advanced lung cancer, uncovering predictive biomarkers of relapse in early-stage disease and improving population health by changing policy on lung cancer screening among never-smokers. With lung cancer being one of the most common cancers in Singapore, we hope that our work will significantly enhance patient survival and improve the quality of life for patients living with this common disease."
The Open Fund-Large Collaborative Grant (OF-LCG) Programme
The OF-LCG supports the efforts of the best research teams in Singapore to conduct patient-centric translational research with the goal of advancing human health and wellness and creating economic value. Cancer is one of the seven areas identified as national priorities for research in Singapore. CLARION is supported by the National Research Foundation, Singapore (NRF) under the NMRC Open Fund-Large Collaborative Grant (MOH-001795) and administered by the Singapore Ministry of Health through the NMRC Office, MOH Holdings Pte Ltd.
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1 Singapore Cancer Registry Annual Report 2022. (2024) National Registry of Diseases Office (NRDO). Retrieved from: https://www.nrdo.gov.sg/docs/librariesprovider3/default-document-library/scr-ar-2022_web-report6c6e8522-cf39-416f-9390-5fe903065927.pdf?sfvrsn=3712e8bb_1
