Covering Disruptive Technology Powering Business in The Digital Age

Authored by: Dr Chee-Onn Leong, CEO – AGTC Genomics

During the pandemic, the importance and usage of genome sequencing were widely seen when the technology was used to sequence the first SARS-CoV-2 viral genome in less than 10 days. This led to the development of effective detection methods such as PCR (Polymerase Chain Reaction) and RTK (Rapid Test Kit), and subsequently the design of the COVID-19 vaccine. Even now with us being in the post-pandemic phase, sequencing technology is still being deployed as a surveillance tool to monitor the emergence of new COVID19 variants and other infectious diseases.

Benefits of Genome Sequencing on Individuals

Being involved in a number of large-scale genome projects and cancer genome projects for more than 15 years, I believe the Malaysian public is in dire need to better understand of the immense benefits of the WGS (Whole Genome Sequencing).

Some of the major benefits include knowing about the elevated risks for known diseases that could help individuals make proactive decisions about their health such as visiting the doctor for more frequent checkups or screenings, choosing one type of prescription drug over another or even altering their diet or exercise plan specially catered to their genetic codes. This saves a lot of trials and errors for those who are struggling to maintain a healthy lifestyle, and help them stay away from preventable diseases such as diabetes, cancers, Alzheimer’s and etc.

Beyond this, the information gained from Personal Genome Sequencing can help people make informed family planning decisions or allow people to make certain kinds of arrangements for their future medical care. Even patients who have a family history of fatal diseases will be more relieved to know that they do not even have the mutation in the first place, and, hence, it will not be passed on to their children.

While all of these are incredible, I believe one of the most promising benefits of genomics and precision medicine is the promise of therapies that are tailored to meet each patient’s specific needs. Healthcare providers can access an individual’s genetic code and better determine what sort of treatment is right for him or her, leading to better outcomes and lower costs. For example, in the management of lung cancer, conventionally, patients are often required to do multiple genetic tests to determine which treatment is better to target the tumour with minimal side effects. These tests can easily cost RM 20,000–RM 30,000 and may require 3–5 tests that will span almost a month to find the right treatment.

However, with the advent of the high-throughput NGS (Next Generation Sequencing) technology, one will only need to perform one test that will cost less than RM10,000 and you will have the right treatment to target the mutated gene in a week’s time. You can see how time-saving and cost-effective this is. Time and cost are critical factors for a cancer patient, and we cannot afford to compromise on any, at all. This is critical information that can help save lives, but in Malaysia, the common practice of having patients go through multiple tests remains incredibly tedious and cost-prohibitive.

The Current Underlying Issue

Even with all these benefits, the awareness of the importance of genomics has been lacking for the past decade in Malaysia while the rest of the world has made tremendous progress in genome research. The utilization of Genome Sequencing Technology in Malaysia is limited because the set up and maintenance of a DNA Sequencing Facility can cost a fortune. Besides that, Malaysia seriously lacks the appropriate technical expertise in this field. Most of our genomics research in Malaysia are outsourced to other developed countries such as Singapore, South Korea, China, the U.S. and the UK. This is an alarming trend because most of the genomic information about our population and biodiversity is now being held on sovereign lands and our overreliance on “outsourcing” has led to a lack of local talent development in this field.

“One of the most promising benefits of genomics and precision medicine is the promise of therapies that are tailored to meet each patient’s specific needs. Healthcare providers can access an individual’s genetic code and better determine what sort of treatment is right for him or her, leading to better outcomes and lower costs.”

This, in turn, has caused Malaysia to lag behind other countries in the genomic race. For example, our neighbouring countries such as Singapore (SG100K), Thailand (Genomics Thailand Initiative) and Vietnam (1KVG) have started their own National Genome Project well before us. Malaysia has yet to embark on a concerted effort to launch its own MGP (Malaysian Genome Project) despite our rich heritage and diversity.

Malaysia as an Independent Genome Sequencing Hub

Fortunately, with the establishment of the first high-throughput Genome Sequencing Lab at AGTC Genomics, Malaysia can now afford to sequence an entire human genome (or any genome) and will not have to rely on “outsourcing” abroad to work at deciphering our own human genomes. With this technology in hand, it is hoped that Malaysia will catch up in the genomic race—to establish its own National Human Genome Project for our future generation.

For instance, in the previously mentioned scenario concerning lung cancer, we can now carry out CGP (Comprehensive Gene Profiling) where more than 500 cancer-related genes can be sequenced in full simultaneously, overcoming the multiple testing cycles to achieve the same treatment decision in less than a week and at only a quarter of the cost.

“Most of the genomic information about our population and biodiversity is now being held on sovereign lands and our overreliance on “outsourcing” has led to a lack of local talent development in this field.”

At AGTC Genomics, we can sequence more than 100 Malaysian Genomes with as little as 2 millilitres of saliva from a healthy individual, at the mere cost of a handphone each (<USD $1,000) in less than 48 hours. With this breakthrough, I am confident that we can pave the way for predictive healthcare and the possibility of identifying why certain people (with particular gene sequences) do not respond to certain medications, including what diseases a particular gene carrier, or a population, is likely to develop. The ongoing genomics revolution, highlighted by Malaysia’s potential to be the new genomic hub in the region with its rich heritage and diversity, promises to change how we predict, prevent and personalise management of diseases with precision.

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