Singapore Launches $25 Million CLARION Program to Transform Asian Lung Cancer Treatment
核心洞察
Singapore's National Cancer Centre receives S$25 million grant to establish CLARION, a comprehensive research program targeting lung cancer treatment specifically for Asian patients.
The program addresses the unique biology of Asian lung cancer, where nearly half of patients are non-smokers with EGFR (搜索)-driven tumors that develop resistance to targeted therapies within 9-15 months.
CLARION focuses on five key areas including drug resistance mechanisms, immunotherapy for never-smokers, biomarker discovery, cellular plasticity targeting, and population-wide screening expansion.
The National Cancer Centre Singapore (NCCS) has secured a S$25 million grant from Singapore's Ministry of Health to launch CLARION (Conquering Lung cancer Across all stages with Research and InnovatiON), an ambitious research program designed to transform lung cancer care for Asian patients. The initiative, announced on July 16, 2025, represents the third consecutive major funding award to the team, following previous grants of S$10 million in 2013 and S$10 million in 2019.
Addressing the Asian Lung Cancer Challenge
Lung cancer presents unique challenges in Asian populations compared to Western countries. In Singapore, three people die from lung cancer daily, making it the deadliest cancer globally. Unlike Western populations where smoking is the primary risk factor, nearly half of Singapore's lung cancer patients have never smoked. These patients frequently develop non-small cell lung cancer (NSCLC) driven by genetic mutations in the EGFR (搜索) gene.
The biological distinctiveness of Asian lung cancer creates significant treatment challenges. While targeted therapies like EGFR (搜索)-tyrosine kinase inhibitors (TKIs) such as osimertinib have improved survival rates over the past two decades, most patients develop drug resistance within 9 to 15 months, leading to cancer recurrence. Even early-stage patients who undergo surgery face relapse risks, with the mechanisms behind drug resistance remaining poorly understood.
Building on a Decade of Research Success
CLARION builds upon over 10 years of established research leadership in Asian lung cancer. Previous work has yielded several breakthrough achievements:
The team identified novel biomarkers and therapeutic targets through cutting-edge genomic tools, data science, and clinical studies, discovering the underlying reasons for drug resistance in lung cancer patients. This enhanced understanding is now being used to develop new therapeutics and treatment approaches.
The Integrated Mutation Profiling of Actionable Cancer Targets (IMPACT) Molecular Tumour Board was established to introduce comprehensive molecular profiling for lung cancer patients in Singapore. This system assigns patients to specific treatments based on their tumor molecular profiling results, representing a systematic implementation of precision medicine approaches.
The team also launched SOLSTICE (The SingapOre Lung cancer Screening Though Integrating CT with other biomarkErs), Singapore's first local lung cancer screening study. SOLSTICE uses low-dose CT scans (LDCT) to detect lung cancer early in at-risk groups, including both smokers and non-smokers with family history of the disease.
Five-Pronged Research Strategy
The CLARION program will focus on five thematic areas to improve outcomes across the entire lung cancer care continuum:
Translational therapeutics will address resistance mechanisms in non-small cell lung cancer, targeting the critical challenge of drug resistance that affects most patients within 15 months of treatment initiation.
Enhanced immunogenicity research specifically targets lung cancer in never smokers (LCINS) to identify druggable targets and develop therapies for this unique patient population that comprises nearly half of Singapore's lung cancer cases.
Biomarker discovery and predictive modeling aims to guide precision oncology approaches, building on the team's previous success in identifying novel therapeutic targets.
Cellular plasticity and resistance targeting focuses on developing novel therapeutics that can address the fundamental mechanisms by which cancer cells evade treatment.
Population-wide lung cancer screening (POPULUS) will study the expansion of LDCT screening for lung cancer at the population level, potentially transforming early detection strategies.
Expert Perspectives on Treatment Innovation
Professor Daniel Tan, CLARION's Corresponding Principal Investigator and Senior Consultant at NCCS, emphasized the program's patient-centered approach: "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, highlighted the focus on drug resistance: "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."
Dr Tee Wee Wei, CLARION Theme 4 Co-Lead and Senior Principal Scientist at A*STAR IMCB, outlined the program's transformative potential: "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."
Collaborative Research Framework
The CLARION program brings together a multidisciplinary team from multiple institutions including NCCS, the National University Cancer Institute Singapore (NCIS), and several A*STAR institutes: the Genome Institute of Singapore (GIS), Institute of Molecular and Cell Biology (IMCB), and Institute of High Performance Computing (IHPC). This collaborative approach combines expertise in medicine, genomics, translational science, and data science.
The program is supported through the National Medical Research Council's Open Fund-Large Collaborative Grant (OF-LCG) programme, which supports Singapore's best research teams in conducting patient-centric translational research. Cancer has been identified as one of seven national research priorities in Singapore, reflecting the government's commitment to advancing oncology research and treatment.