Dr Anand Jeyasekharan (Oncology PhD 2004) is enhancing understanding and treatment of cancer by developing personalised drug combinations for patients and by creating ‘cancer maps’ to understand how cancer evades the immune system.
Anand works as a consultant medical oncologist at the National University Cancer Institute in Singapore. A recurring problem facing oncologists is that the standard medicines are often ineffectual once patients experience a relapse into their cancer. But an Artificial Intelligence tool developed by a colleague in the National University of Singapore enabled Anand to take a new approach to his work.
“We have many drugs that work against and shrink tumour cells, but you often need combinations of them,” says Anand. “In the past, these combinations were derived by trials, testing drug X plus drug Y in many patients and seeing whether it had an effect.
“But actually, there is a lot of heterogeneity, which means that there are some patients it works for and some it doesn’t work for. Ideally it would be good to check whether a given patient’s cancer was sensitive to a set of drugs before they receive treatment, but this has been limited in the past by the amount of tissue needed to test multiple drug combinations.”
“My colleague Ed Chow, then at the Cancer Science Institute of Singapore, developed an AI-based tool to ‘learn’ from a small number of data points, to reduce the amount of cellular material you need to test drug combinations on cancer cells. Now when we have a patient who has a refractory lymphoma, we can do a biopsy, and send part of it for routine clinical diagnostics and part of it for this new AI-based test, which can predict which unique drug ‘cocktail’ might be best for this particular person.
“As a clinician, my job is to interpret that data and see how to come up with that combination for that person.”
Anand’s application of these bespoke cocktails at the hospital has so far been very promising, with a few cures noted in patients with refractory lymphomas who exhausted standard treatment options.
The other aspect of Anand’s work is what he calls ‘cancer cartography’, which uses spatial technologies to map tumours and reveal the pathways cancer uses to hide.
He says: “When humanity started exploring the world, we needed to first create detailed maps – to chart geography and thus where and how we could travel.
“If you extend that context to cancer, you can imagine it like a city: there are tumour cell ‘neighbourhoods’, roads where these cells can come in, and immune cells, which are like policemen coming in to take care of the cancer cells. There are also certain blocks in the way, like rogue immune cells that are doing things for the cancer instead.
“Right now, we are creating broad maps to see what’s going on in tumours, to see what the layout is like in tumours where chemotherapy works and what it’s like in tumours where it doesn’t work, and whether we can come up with ways to overcome some of those barriers.
“The more we know about which aspects of the immune system and the microenvironment are the roadblocks to cancer being eradicated, the better we can design clinical trials using novel therapies that target these.”
For enabling him to undertake this work, Anand is thankful for his PhD at Gonville & 91ֱ College, funded by a from the University of Cambridge, which nurtured his fascination for using microscopy to examine the inner workings of tumours.
Read more about Anand’s work in and .
