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Personalised Medicine, also often termed as Precision Medicine, is a form of medicine that uses information about a person's genes, proteins, and environment profile to prevent, diagnose, and treat disease.

However, it does not literally refer to the creation of a drug or medication that is unique to a specific patient, but the ability to classify individuals into subpopulations that differ in their susceptibility to particular disease, in the biology or prognosis of those diseases they may develop, or in their response to a specific treatment.

The goal of Personalised Medicine is to target the RIGHT treatment to the RIGHT patients at the RIGHT time. Personalised Medicine adds to, and does not replace, good medical practice. However, Personalised Medicine is not equally applicable to all diseases.

​Tan Tock Seng Hospital recognises that Personalised Medicine is playing an increasingly important role in clinical practice. Therefore, the Personalised Medicine Service was established in June 2015 to provide genetic testing services and individualised treatment.

The Service has three focus areas:

  1. Pharmacogenomics

    Pharmacogenomics uses genetics and genomics tools to study drug response due to genetic factors and makes a prediction of your response to specific medications and susceptibility to toxicity and adverse effects.
  2. Clinical Genomics

    This aim of this service is to use genomics to guide treatment of cancers and complex chronic diseases. The management of some conditions can be optimised with a variety of laboratory tests, though the range of tests is small, the number is ever-increasing. Personalised Medicine also has the potential to be applied to the management of chronic diseases such as ischaemic heart disease, asthma, diabetes, and arthritis.
  3. Rare Disease

    This section employs modern genomics to diagnose patients suffering from diseases that yielded no definite diagnosis with conventional tests. Modern sequencing technology allows up to 25% of these patients to be diagnosed (Yang Y, Muzny DM, Reid JG, et al. N Engl J Med 2013; 369:1502-11). However, in spite of a diagnosis, treatment may not be available.


​The Molecular Diagnostic Laboratory (MDL) is a College of American Pathologists (CAP)-accredited clinical laboratory offering a comprehensive range of genomic diagnostics using innovative technologies. Our team of laboratory scientists work in close collaboration with clinical colleagues, industries and academic institutions to accelerate our mission of advancing healthcare. With a focus on personalized medicine, MDL is particularly interested in understanding the role of genetic variations in drug response and toxicity with the hope of translating this information into new diagnostics and treatment strategies.

​MDL provides a centralized platform to support genomics and pharmacogenomics from research to clinical practice. Our core facilities support sample processing, nucleic acid extraction, bio-banking, genotyping and next generation sequencing among other specialized services. The research service includes consultation on study design, informed consent, data collection and assistance with manuscript and grant preparation. These enable the exploration of the relationships among genetic variant, disease susceptibility and variable drug responses. Research services are offered through fee-of-service as well as collaborative mode.

Pharmacogenetics

Test Description

Indication

Turnaround Time

Specimen Type & Requirement

CYP2C19
Genotyping

To predict anticoagulation response to clopidogrel and other drugs that are modified by CYP2C19.

3-5

Whole blood
(EDTA, 3ml), 2 tubes

OR

2 Buccal swabs (dry, non-gel Cultiplast swab)

CYP3A5
Genotyping

To predict dose requirements for tacrolimus and other drugs that are modified by CYP3A5.

CYP2D6 Genotyping

To identify individuals who should avoid or have different dosing of medications metabolized by CYP2D6.

HLA-B*1502
Genotyping

To identify individuals with increased risk for a hypersensitivity reaction to carbamazepine.

TPMT and
NUDT15
Genotyping

To predict toxicity to thiopurines.

Warfarin Genotyping

To determine the optimal initial dose of warfarin based on CYP2C9 and VKORC1 genotypes.

Oncology

BCR-ABL1 p210 Fusion Transcript Analysis

To monitor response to therapy in chronic myeloid leukemia patients who have the BCR-ABL p210 fusion form (e13/a2 or e14/a2).

7-10

Whole blood or bone marrow (EDTA, 3ml), 2 tubes
Specimen must reach MDL within 72 hours of blood draw

CALR Exon 9 Mutation Detection

To aid in the distinction between reactive thrombocytosis and/or leukocytosis versus a myeloproliferative neoplasm (MPN).

5-7

Whole blood or bone marrow (EDTA, 3ml), 2 tubes

JAK2 V617F Mutation Detection

To aid the diagnosis of bone marrow disorders.
(This test does not differentiate between heterozygous and homozygous status.)

JAK2 Exon 12/13 HRM Mutation Analysis

To aid the diagnosis of bone
marrow disorders.
(JAK2 exons 12 and 13 testing should be performed in JAK2 V617F negative individuals.)

7-10

JAK2 V617F, CALR Exon 9 and MPL Exon 10 Mutation Detection

To aid the diagnosis of bone marrow disorders.

MPL Exon 10 Mutation Analysis

To aid the diagnosis of bone marrow disorders.

5-7

BRAF V600E Mutation Analysis

An alternative to invasive tissue biopsies to guide the treatment of individuals for targeted therapies. It is also used to differentiate hairy cell leukemia from other B-cell lymphomas with similar clinical and morphologic features.

3-5

Hematologic malignancy:
Whole Blood (EDTA, 3ml), 2 tubes

Liquid biopsy: Whole blood
(STRECK), 2 tubes

EGFR Liquid Biopsy Analysis

An alternative to invasive tissue biopsies to test for the presence of EGFR activating mutations that may benefit from certain EGFR inhibitor therapies.

3-5

Whole blood
(STRECK), 2 tubes

Liquid biopsy for solid tumors

An alternative to invasive tissue biopsies to detect cancer causing gene mutations for cancer diagnosis and treatment selection.
(Send out test)

7-10

Whole blood
(STRECK), 2 tubes

IDH1/2 Mutation Analysis

To aid classification of gliomas and predict better prognosis and better response to chemotherapy.

7-10

1 H&E stained slide and 8 unstained slides (5 microns each)
Pathology report must accompany specimen. 

MGMT Promoter Methylation Analysis

To predict response to alkylating chemotherapy.

5-7

Hereditary disease and disorder (Send out test)
NOTCH3 Mutation Analysis*To aid in the diagnosis of CADASIL.10 to 14 working daysWhole blood

(EDTA, 3ml), 2 tubes​ ​ ​
​Multiple Cancers panels* (Breast, Ovarian, Colon, Gastric, Pancreas, Prostate)​To detect specific genetic mutations for targeted cancer treatment or evaluate individuals with family history suggestive of predisposition to cancers.

 

Sponsorship for testing available for Breast, Ovarian, Pancreas or Prostate cancers

​10-14
​Cardiology*​To assist with risk assessment and predictive testing of at-risk family members for Bruguda, prolonged QT syndromes or cardiomyopathy.​10-14
​Whole exome sequencing*​To identify a molecular diagnosis in individuals with known or suspected genetic disorders for targeted management, risk assessment or reproductive decision making. ​20-40
Others
​DNA extraction​Sample processing ​
​1-2

Whole blood

(EDTA, 1-3ml)​

​RNA extraction

Whole blood

(EDTA, Paxgene, 1-3ml)​

​Targeted sequencing*(research service only)​To detect specific variant(s)
Must be pre-arranged.
​20-40

Whole blood

(EDTA, 3ml), 2 tubes​

​GastroclearThis screening test evaluates the expression of 11 circulating human miRNAs associated with gastric cancer and 1 reference miRNA. It should be used in conjunction with gastroscopy to detect stomach cancer.​7-10

Whole Blood (SST, 6ml), 1 tube

Please hand deliver samples in cold to MDL within 2 hours after blood collection.

Sample receipt timing: 8.30am – 4.30pm on Weekdays only.

* Consent required



​​For general personalised medicine enquiry, please email to personalised_medicine@ttsh.com.sg

For molecular diagnostic testing, please contact Molecular Diagnostic Laboratory

  • Operating Hours
    Open Monday to Friday, 8.30am to 5.30pm. Close on Saturday, Sunday and Public Holidays
  • Email: Mdl_enquiry@ttsh.com.sg
  • Contact no: 6357 7389
















2019/11/28
Last Updated on