Revolutionising cancer detection, one gene at a time

loading Osel Clinic on Macalister Road.

Prof Datuk Dr Choong-Chin Liew has many feathers in his cap – studying under one of the co-founders of insulin being one of them. Liew is perhaps most famously known for being a pioneer in the field of molecular medicine and as a leader in tissue-specific functional genomics.

And last February, he added yet another milestone to his achievements: the opening of the GeneNews Diagnostics research and development facility. This facility, of which Liew is chairman and chief scientist, is in partnership with holistic boutique medical centre Osel Clinic and aims to put Penang at the forefront of medical research and diagnostics.

Thus, with GeneNews Diagnostics, which will be introducing new propriety genomic technology products including the world’s first blood test for colorectal cancer risk stratification, Penang has come yet another step closer to being in the forefront in the field. Penang Monthly chats with Liew to find out more about the technology and philosophy behind the facility.

Can you tell us what the facility is all about?

Choong-Chin Liew: First of all, GeneNews Limited (an Ontario incorporated company) is the parent company, and I am one of the founders. GeneNews Diagnostics, on the other hand, was created for the company, is housed in Malaysia and is half-owned by Malaysians.

The technology is patented by GeneNews. But a lot of new things do occur in the process, and the technology does evolve new and interesting aspects. I concentrate on creating a multipledisease panel to do detection work; it then becomes a product of GeneNews Diagnostics. We have collected all sorts of patients for the liver cancer project, and right now we are concentrating on getting the multiple-disease panel together because it is Osel Clinic’s vision to make regenerative medicine a priority.

What is the methodology behind the multiple-disease panel and ColonSentry (the test for colorectal cancer risk stratification)?

We adopted a very simple process – the drawing of blood. The blood drawn instantly reflects the current state of your body. After getting the blood, we process it to get the messenger out in the lab. This is a very routine procedure – anyone who knows science can do it. From there, we use reverse transcriptase to turn the RNA into complementary DNA (cDNA). Then, using a specific probe to detect each different allele, we may share the quantitative or copy of the messenger allele. We derive an algorithm to predict whether the risk (of cancer) is higher or lower, and send out the report to the client.

How is what you’re doing different from cancer marker screening?

Cancer marker screening is usually done on DNA, and DNA is 99.9% identical among all of us. What cancer marker screening does is measure the variations of mutations – these are inherited. What we are doing is looking at the messenger RNA – that’s when we concentrate only on the signals coming from the DNA.

Liew showing the Chief Minister and Anwar Fazal, renowned Penang consumer activist, around the lab.\.

A test like this sounds costly...

In medical practice, everything starts out at a very high price – for example, for HIV and cardiovascular diseases, treatment was very expensive at the beginning; stent treatment cost thousands of dollars, but now in China, it’s only at a few hundred RMB. It’s not the profession that does not want to lower the price – it’s the whole commercial world. We are buying the reagent (for our tests) for US$240,000. You multiply that by three. That’s just what we are stuck with.

In the beginning, what inspired you to carry out research in this area?

We were taught in high school and university that each tissue has a specific messenger RNA to make the brain and heart function. Fifteen years ago, I found out that I could detect the insulin expression gene – which is supposed to be in the pancreas – in the blood. Iwas a student of Prof Charles Best who discovered insulin, so during that time, I kind of went, “Wow, how come (the insulin expression gene) is in the blood?” That got me thinking that all genes can be expressed on a very minimal level; depending on the state of a person and the state of the disease, the type of gene will be expressed differently. Disease occurs when you disturb a balance; that’s when it starts.

Thumbs up for the Chief Minister. He had himself tested during the opening of GeneNews Diagnostics.

Moving forward, what else is in the pipeline?

Cancer research is very important for people who discover their disease in the late stages – during the terminal stage. What you can do is to try to take care of the patient in a comfortable way; only cancers detected early enough may be curable, or its onset delayed. Prostate cancer is now recognised to be very aggressive or indolent. It is globally acknowledged that the prostate-specific antigen (PSA) test is not enough to guide physicians, so we have to look for the specific messenger RNA to distinguish the aggressive type from the indolent type. This is the way people now look at active surveillance on all cancer types.

On top of that, we are planning to kick off the multiple-disease screening panel in the middle of this year, beginning in Penang.

Why Penang?

It’s a long story. I was born in a small town called Sungai Siput, Perak. Nobody knows about the place; it’s such a tiny place (chuckles). I went to high school here at Chung Ling, so very naturally I got to like Penang. I had finished my bachelor’s degree at Nanyang University, Singapore when I got an unexpected offer by Prof Best to study at the University of Toronto.

I have been in the best schools since I left Malaysia – I was in the best medical school in Canada, I did my post-doctorate in Cambridge and I was in Rockefeller University in New York City. Subsequently, I was a professor at Toronto, then a professor at Harvard. I am already known in my field. Deep down in my heart, I wanted to do something for the country.

Julia "Bubba" Tan is assistant editor for Penang Monthly.

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