News & Updates

Sotorasib offers a paradigm shift in the treatment of KRAS G12C-mutated NSCLC

Kirsten rat sarcoma viral oncogene (KRAS) mutations are common in non-small cell lung cancer (NSCLC) and are associated with poor prognosis, likely due to poor responses to most systemic therapies and lack of targeted therapies. At a recent webinar organized by Amgen, Associate Professor Daniel Tan from the National Cancer Centre, Singapore, gave an overview of the biomarker testing landscape in NSCLC. Associate Professor Thomas John from the Peter MacCallum Hospital, Australia, addressed the optimal treatment strategy for KRAS-mutant NSCLC and the role of sotorasib, a first-in-class RAS GTPase family inhibitor approved in Singapore for the treatment of adults with KRAS^G12C-mutated locally advanced or metastatic NSCLC who have received at least one prior systemic therapy.

Challenges in the diagnosis and management of multidrug-resistant gram-negative infections: Real-world evidence and experience

The diagnosis and treatment of multidrug-resistant (MDR) gram-negative bacteria in critically ill patients present many clinical challenges. Selection of appropriate antibiotic therapy in a timely manner requires patients’ comprehensive medical history, updated local knowledge of microbiological epidemiology, efficient use of diagnostic tools, and balancing of information from clinical trial data, real-world evidence (RWE), and guidelines.

In a symposium Pfizer organized in conjunction with the Asia Pacific Intensive Care Symposium (APICS), Professor David Paterson from the National University of Singapore discussed the importance of RWE in the antibiotic armamentarium, using ceftazidime-avibactam (CAZ-AVI, Zavicefta^®) as an example. Dr Asok Kurup, Consultant Infectious Diseases Physician at Mount Elizabeth Medical Centre, Singapore, explained how rapid diagnostics can guide treatment choices to improve patient outcomes in MDR gram-negative infections.

Timely treatment of patients at risk for severe COVID-19 prevents severe outcomes

Despite widespread uptake of vaccinations, COVID-19 remains a serious health issue for high-risk patients, owing to the emergence of new variants of concern (VOCs), waning immunity, and breakthrough infections.

At a recent symposium in Singapore, esteemed experts Dr Asok Kurup, Consultant Infectious Diseases Physician at Mount Elizabeth Medical Centre, Singapore, and Dr Alex Soriano, Head of Infectious Diseases Department, Hospital Clínic of Barcelona and Assistant Professor, University of Barcelona, Spain, gave insights on the evolution of global trends since the start of the COVID-19 pandemic and discussed key challenges in managing high-risk patients with COVID-19 in the ICU. They also highlighted early treatment strategies to minimize the burden of COVID-19 on healthcare systems.

AZD7442 (tixagevimab–cilgavimab) prevents COVID-19 in high-risk populations

Though most COVID-19 safe management measures have been lifted in Singapore, the pandemic continues to adversely impact the lives of immunocompromised patients at high risk of severe infection. 

“It has been an absolute misery for these patients and their families,” said Dr Leong Hoe Nam, Infectious Disease Specialist at Mount Elizabeth Novena Hospital, Singapore. “The virus is an unseen enemy that may strike unexpectedly. The strike may kill, or if not, maim the individual. Patients isolate themselves for fear of getting infected while their family members fear bringing the illness back home.” 

Immunocompromised patients are those with suppressed immunity resulting from health conditions, including solid organ and haematological cancers, end-stage kidney and liver disease, organ or bone marrow transplants, and immune-mediated inflammatory diseases such as rheumatoid arthritis, or those on active treatment with immunosuppressive medications. [Expert Rev Vaccines 2022;1-17; BMJ 2021;374:n2098]

Dapagliflozin DELIVERs across full HF spectrum regardless of LVEF

The selective, oral sodium–glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin reduces the risk of cardiovascular (CV) death or worsening heart failure (HF) in patients with HF and mildly reduced or preserved ejection fraction (HFmrEF or HFpEF) in the phase III DELIVER* trial, touted as the largest and most inclusive thus far in this patient group.

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Early diagnosis and treatment of transthyretin amyloid cardiomyopathy significantly improves outcomes

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a significantly underdiagnosed, life-threatening disease caused by the deposition of transthyretin amyloid fibrils in the heart. Dr Soon Chao Yang, Interventional Cardiologist at The Heart Doctors Clinic in Mount Alvernia Hospital, Singapore, reviews the data on early treatment of ATTR-CM, and shares his clinical experience with tafamidis.

Optimizing anticoagulation therapy for atrial fibrillation with prior gastrointestinal bleeding

Long-term anticoagulation therapy is often recommended for patients with atrial fibrillation (AF) to reduce their risk of stroke, but gastrointestinal bleeding (GIB) is a common complication that presents a significant challenge. Patients with a history of GIB have heightened risks of recurrent bleeding events, hence interruption or discontinuation of anticoagulants is often warranted. When and how to restart anticoagulant therapy following an episode of GIB has been debated. MIMS Doctor interviewed Dr Pipin Kojodjojo, Cardiologist and Cardiac Electrophysiologist at Asian Heart & Vascular Centre, Singapore, to gather his perspectives on how to manage anticoagulant therapy after a GIB episode.

Tafamidis still the only approved therapy for ATTR-CM in Asia

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressively debilitating disease with a formidable symptom burden and an average survival of 2–5 years from diagnosis. In 2019, the US Food and Drug Administration approved tafamidis (Vyndamax) as the first disease-modifying therapy for ATTR-CM. Since then, tafamidis has been approved for the treatment of ATTR-CM in over 55 countries including Japan, Australia, and Singapore. MIMS Doctor interviewed Dr Tang Hak Chiaw, consultant cardiologist at Novena Heart Centre, Singapore, about the types and clinical presentation of ATTR-CM in Singapore, and the role of tafamidis in the treatment of this often underdiagnosed and fatal disease of the heart muscle.

Management of multidrug-resistant organisms in paediatric patients: Role of newer antimicrobial agents

The management of multidrug-resistant (MDR) infections in children is complex, with limited studies and a relative lack of approved new antibiotics with paediatric indications.

At a recent Meet-the-Expert session, Dr Louis Grandjean, Consultant in Paediatric Infectious Diseases at Great Ormond Street Hospital and Associate Professor at University College, London, UK, addressed the growing threat of MDR infections in children and discussed treatment strategies and options for management. He focused on ceftazidime-avibactam (CAZ-AVI, Zavicefta^®), whose approval in Singapore was recently expanded to include paediatric patients aged 3 months and older.

Adj Asst Prof Natalie Tan, Senior Consultant at KK Women’s and Children’s Hospital, Singapore, chaired this webinar, which was organized by Pfizer under the auspices of the Singapore Paediatric Society and KK Women’s and Children’s Hospital.