Featured Publications
Phase I PIANO trial—PIPAC-oxaliplatin and systemic nivolumab combination for gastric cancer peritoneal metastases: clinical and translational outcomes
Sundar R, Chia D, Zhao J, Lee A, Kim G, Tan H, Pang A, Shabbir A, Willaert W, Ma H, Huang K, Hagihara T, Tan A, Ong C, Wong J, Seo C, Walsh R, Chan G, Cheo S, Soh C, Callebout E, Geboes K, Ng M, Lum J, Leow W, Selvarajan S, Hoorens A, Ang W, Pang H, Tan P, Yong W, Chia C, Ceelen W, So J. Phase I PIANO trial—PIPAC-oxaliplatin and systemic nivolumab combination for gastric cancer peritoneal metastases: clinical and translational outcomes. ESMO Open 2024, 9: 103681. PMID: 39288528, PMCID: PMC11421236, DOI: 10.1016/j.esmoop.2024.103681.Peer-Reviewed Original ResearchConceptsGastric cancer peritoneal metastasisPeritoneal cancer indexNivolumab combinationPeritoneal metastasisPeritoneal tumorsNaive CD8+ T cellsCD8+ central memoryEnhanced T cell infiltrationTreatment-related adverse eventsCD8+ T cellsGrade 4 vomitingRegression grade 1First-in-human trialImmune checkpoint inhibitionMemory CD4+T cell infiltrationImmunogenic cell deathSystemic immunotherapyCheckpoint inhibitionSystemic therapyCancer indexCD4+Intraperitoneal treatmentT cellsAdverse events
2023
Clinical outcome and prognostic factors for Asian patients in Phase I clinical trials
Loh J, Wu J, Chieng J, Chan A, Yong W, Sundar R, Lee S, Wong A, Lim J, Tan D, Soo R, Goh B, Tai B, Chee C. Clinical outcome and prognostic factors for Asian patients in Phase I clinical trials. British Journal Of Cancer 2023, 128: 1514-1520. PMID: 36797357, PMCID: PMC10070409, DOI: 10.1038/s41416-023-02193-2.Peer-Reviewed Original ResearchMeSH KeywordsBreast NeoplasmsFemaleHumansLymphocytesNeutrophilsPatient SelectionPrognosisRetrospective StudiesTreatment OutcomeConceptsNeutrophil-lymphocyte ratioRoyal Marsden HospitalPhase I studyPhase I clinical trialPoor ECOG statusPre-treated patientsPrimary tumor sitePhase I populationLonger-term survivalECOG statusPrognostic factorsPrognostic scoreRetrospective reviewTumor siteAsian patientsSolid tumorsClinical outcomesPoor prognosisBackgroundPatient selectionPrognostic abilityPrognostic modelPatientsPrognosisIncreased scoresScoresClinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients.
Lee M, Peng S, Lee A, Wong S, Tay R, Li J, Tariq A, Goh C, Tan Y, Tan B, Teo C, Chan E, Ooi M, Chng W, Chee C, Ho C, Walsh R, Wong M, Su Y, Alexander L, Sethi S, Tan S, Chan Y, Tan K, Lee S, Chai L, Sundar R. Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients. Annals, Academy Of Medicine, Singapore 2023, 52: 8-16. PMID: 36730801, DOI: 10.47102/annals-acadmedsg.2022302.Peer-Reviewed Original ResearchMeSH KeywordsAntibodies, ViralCOVID-19Hematologic NeoplasmsHumansImmunogenicity, VaccineNeoplasmsRNA, MessengerSARS-CoV-2Treatment OutcomeVaccinationConceptsSARS-CoV-2 mRNA vaccinesDoses of SARS-CoV-2 mRNA vaccinesMRNA vaccinesCancer patientsThird doseHaematological malignanciesLong-term immunogenicityCompared to patientsRisk of severe diseaseAnti-neoplastic treatmentActive cancer therapyVirus neutralisation assaySARS-CoV-2 infectionSystemic chemotherapyNo patientEarly administrationSeroconversion ratesVaccine immunogenicitySolid tumorsClinical efficacyClinical outcomesSevere infectionsCancer therapyHumoral responseActive treatment
2022
Phase Ib Dose-Finding Study of Varlitinib Combined with Weekly Paclitaxel With or Without Carboplatin ± Trastuzumab in Advanced Solid Tumors
Lee M, Wong A, Ow S, Sundar R, Tan D, Soo R, Chee C, Lim J, Yong W, Lim S, Goh B, Wang L, Lee S. Phase Ib Dose-Finding Study of Varlitinib Combined with Weekly Paclitaxel With or Without Carboplatin ± Trastuzumab in Advanced Solid Tumors. Targeted Oncology 2022, 17: 141-151. PMID: 35195837, PMCID: PMC8995271, DOI: 10.1007/s11523-022-00867-0.Peer-Reviewed Original ResearchConceptsHER2+ metastatic breast cancerDose-limiting toxicityMetastatic breast cancerBreast cancerSubcutaneous trastuzumabSolid tumorsConclusionsThe recommended phase II dosePharmacokinetic analysisRecommended phase II doseHER2+ breast cancerAdvanced solid tumorsPalliative systemic therapyMetastatic solid tumorsResultsThirty-seven patientsArea under the curveWeekly paclitaxelNeoadjuvant therapyStable diseaseFebrile neutropeniaPartial responseSystemic therapyMethodsEligible patientsEfficacy signalsElectrolyte disturbancesBiliary tractUNOS Down-Staging Criteria for Liver Transplantation of Hepatocellular Carcinoma: Systematic Review and Meta-Analysis of 25 Studies
Tan D, Lim W, Yong J, Ng C, Muthiah M, Tan E, Xiao J, Lim S, Pin Tang A, Pan X, Kabir T, Bonney G, Sundar R, Syn N, Kim B, Dan Y, Noureddin M, Loomba R, Huang D. UNOS Down-Staging Criteria for Liver Transplantation of Hepatocellular Carcinoma: Systematic Review and Meta-Analysis of 25 Studies. Clinical Gastroenterology And Hepatology 2022, 21: 1475-1484. PMID: 35181565, DOI: 10.1016/j.cgh.2022.02.018.Peer-Reviewed Original ResearchConceptsUNOS-DS criteriaHepatocellular carcinoma recurrenceUNOS-DSDown-stagingOverall survivalLiver transplantationHepatocellular carcinomaMilan criteriaPost-LTLiver transplantation of hepatocellular carcinomaTransplantation of hepatocellular carcinomaAbstractText Label="RESULTS">WeAdult HCC patientsBaseline tumor burdenPost-LT outcomesDown-staging treatmentTumor burdenHCC patientsEmbase databasesPooled analysisPatientsIndividual participant dataRecurrenceClinical validationMeta-analysis
2019
Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy
Bandla A, Tan S, Kumarakulasinghe N, Huang Y, Ang S, Magarajah G, Hairom Z, Lim J, Wong A, Chan G, Ngoi N, Ang E, Lee Y, Chan A, Lee S, Thakor N, Wilder-Smith E, Sundar R. Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy. Supportive Care In Cancer 2019, 28: 3691-3699. PMID: 31811482, PMCID: PMC7316694, DOI: 10.1007/s00520-019-05177-2.Peer-Reviewed Original ResearchConceptsNerve conduction studiesTotal Neuropathy ScoreFrozen glovesTaxane chemotherapyNeuropathy scorePeripheral neuropathyDose-limiting toxicityConcomitant with chemotherapyTaxane-induced peripheral neuropathySeverity of neuropathySensory nerve amplitudesPrevention of neurotoxicitySkin temperature reductionLimb hypothermiaMonths post-chemotherapyPaclitaxel chemotherapyNerve amplitudeMotor amplitudeSevere neuropathyPost-chemotherapyUndesired side effectsChemotherapyCancer patientsNeuropathySide effects
2018
Real-Time Tumor Gene Expression Profiling to Direct Gastric Cancer Chemotherapy: Proof-of-Concept “3G” Trial
Yong W, Rha S, Tan I, Choo S, Syn N, Koh V, Tan S, Asuncion B, Sundar R, So J, Shabbir A, Tan C, Kim H, Jung M, Chung H, Ng M, Tai D, Lee M, Wu J, Yeoh K, Tan P, Consortium O. Real-Time Tumor Gene Expression Profiling to Direct Gastric Cancer Chemotherapy: Proof-of-Concept “3G” Trial. Clinical Cancer Research 2018, 24: 5272-5281. PMID: 30045931, DOI: 10.1158/1078-0432.ccr-18-0193.Peer-Reviewed Original ResearchConceptsGenomic classifierManagement of advanced gastric cancerGastric cancerS-1 regimenOpen-label phaseAdvanced gastric cancerGastric cancer chemotherapySensitivity to oxaliplatinTreated with cisplatinTumor gene expressionMedian turnaround timeTreated with SPGene expression signaturesSOX chemotherapyPatient tumorsTreatment stratificationStratify patientsMetabolic signaturesChemotherapyGene expression profilesOxaliplatinPatientsCancer chemotherapyPredictive valueResponse rate
2017
Clinical Outcome of Patients with Advanced Biliary Tract Cancer in a Dedicated Phase I Unit
Sundar R, Custodio A, Petruckevich A, Chénard-Poirier M, Ameratunga M, Collins D, Lim J, Kaye S, Tunariu N, Banerji U, de Bono J, Lopez J. Clinical Outcome of Patients with Advanced Biliary Tract Cancer in a Dedicated Phase I Unit. Clinical Oncology 2017, 30: 185-191. PMID: 29224898, DOI: 10.1016/j.clon.2017.11.011.Peer-Reviewed Original ResearchConceptsAdvanced biliary tract carcinomaPhase I clinical trialPhase I unitABC patientsAdvanced biliary tract cancerMolecular characterisation of tumoursClinical outcomes of patientsClinical benefit rateBiliary tract carcinomaBiliary tract cancerComprehensive molecular profilingPhase I trialOutcomes of patientsCharacterisation of tumoursStable diseaseI unitsAdvanced diseaseI trialBenefit rateTargeted therapyTreatment detailsTrial discontinuationExceptional respondersPTEN lossClinical outcomes
2016
Phase Ib/II randomized, open-label study of doxorubicin and cyclophosphamide with or without low-dose, short-course sunitinib in the pre-operative treatment of breast cancer
Wong A, Sundar R, Wang T, Ng T, Zhang B, Tan S, Soh T, Pang A, Tan C, Ow S, Wang L, Mogro J, Ho J, Jeyasekharan A, Huang Y, Thng C, Chan C, Hartman M, Iau P, Buhari S, Goh B, Lee S. Phase Ib/II randomized, open-label study of doxorubicin and cyclophosphamide with or without low-dose, short-course sunitinib in the pre-operative treatment of breast cancer. Oncotarget 2016, 7: 64089-64099. PMID: 27577069, PMCID: PMC5325427, DOI: 10.18632/oncotarget.11596.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnthracyclinesAntineoplastic AgentsBiomarkers, TumorBreast NeoplasmsContrast MediaCyclophosphamideDisease-Free SurvivalDoxorubicinDrug Administration ScheduleFemaleHumansImmunohistochemistryIndolesMagnetic Resonance ImagingMiddle AgedNeoadjuvant TherapyPreoperative PeriodPyrrolesSunitinibTreatment OutcomeConceptsPathological complete responseVascular normalization indexChemotherapy dose delaysLow-doseDose delaysDCE-MRIPhase IbDecreased lymphatic vessel densityIntra-tumoral drug deliveryPathologic complete response rateRecommended phase II dosePhase II doseDose of sunitinibTreatment of breast cancerDCE-MRI parametersPre-operative treatmentAnthracycline-based chemotherapyOpen-label studyRandomized to chemotherapyTumor vessel normalizationLymphatic vessel densityEnhance chemotherapy efficacyBreast cancer patientsFunctional imaging biomarkersPharmacodynamic evidence