Sarthak Ranade, Area Managing Director of Johnson & Johnson Innovative Medicine for SEA and India, believes the era of precision medicine is no longer a distant vision but an emerging reality. With Singapore taking bold strides through national initiatives like SG100K and the National Precision Medicine programme, the foundations are being laid for a more personalised, predictive and proactive healthcare system. However, to truly embed precision medicine into everyday care, we must overcome systemic hurdles in digital infrastructure, clinical readiness and public trust in genetic data handling.

Can a simple genetic test enable doctors to tailor treatment specific to individuals right from the start? 

The short answer is yes, as such treatments exist today – from catching diseases earlier and reducing side effects, thus making treatments more effective. This is the potential of precision medicine, where treatment shifts from a traditional one-size-fits-all approach to one that is far more personal. 

Currently, Singapore leads the region in personalised and preventive care. Initiatives like the SG100K genetic study, which aims to build one of the largest genetic databases in Asia, mark a significant milestone in the country’s precision medicine efforts. 

The National Precision Medicine programme is also accelerating research to develop more targeted treatments for Singapore’s diverse population. With these large-scale initiatives, the country is laying the groundwork for a more personalised and proactive healthcare system. 

But are we ready to fully integrate precision medicine into everyday healthcare, even with these efforts? 

One of the biggest challenges is weaving genetic data into the current healthcare system. While electronic health records are widely used, they are not entirely designed to handle complex genetic information. Furthermore, doctors need easy-to-use tools that can support them to interpret this data and apply it effectively in treatment decisions. 

Healthcare professionals also require the proper training to incorporate these genetic insights into their care decisions because precision medicine might not reach its full potential without the right expertise. 

Beyond infrastructure and training, there is also the issue of trust. Genetic data is deeply personal, and many people are concerned about how it will be used, stored, and protected. Clear policies and transparent communication are needed to prevent patients from feeling concerned about undergoing genetic testing, even though it could lead to better outcomes. 

Therefore, to fully embrace the potential of precision medicine, we must implement crucial elements that will enable success. 

First, healthcare institutions must develop clinical decision-support tools that seamlessly integrate genetic insights into medical workflows. These tools should be user-friendly, provide clear, clinically relevant recommendations and not overwhelm the clinician with raw genetic data. 

AI-driven platforms and automated analysis can help healthcare professionals quickly interpret test results and link them with the most effective treatment options. Additionally, healthcare providers should collaborate with molecular pathologist to create a more seamless referral pathway that leads to faster patient outcomes. 

Secondly, to empower healthcare professionals with the right knowledge, investments in education and training must continue. Medical schools have already incorporated precision medicine into their curriculums, but we also need to provide ongoing professional development for doctors already in the practice. 

Hands-on workshops, online courses, and collaborations with genetic specialists and molecular pathologists can help ensure that healthcare professionals are more confident using genetic data to guide patient treatment outcomes. Furthermore, the public and private sectors can collaborate to provide incentives and funding to encourage more professionals to pursue specialisations in medical genetics. 

Thirdly, regulatory frameworks must be strengthened to ensure robust data privacy protections. Patients should have full control over their genetic information with clear guidance on who can access it and how it will be used. Establishing oversight to monitor the ethical use of genetic data could further enhance public confidence. Health Minister Mr Ong Ye Kung echoes this, as the government has imposed strict moratoriums on the insurance industry against genetic discrimination in health insurance coverage. 

There is also a need for more nationwide public awareness campaigns that can help demystify precision medicine. Utilising real-life success stories from patients who have seen better outcomes with precision medicine can further illustrate the benefits and alleviate concerns about data misuse. 

On that note, let me share how precision medicine helps in the treatment of lung cancer. Lung cancer is a significant health crisis in Singapore. Alarmingly, fewer than 20% of patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC) survive beyond five years1. It's important to understand that lung cancer does not discriminate; it can affect anyone, including non-smokers, and nearly 70% of NSCLC patients are diagnosed at advanced stages, making timely treatment crucial2.

Precision medicine enhances lung cancer treatment by personalizing therapies based on the genetic makeup of each patient's tumour.  For example, EGFR is a protein on the surface of cells that helps them grow and divide. In some cancers, EGFR is overexpressed or mutated, leading to uncontrolled cell growth. By identifying specific mutations, such as EGFR, doctors can prescribe the right anti-EGFR therapy to slow down or stop cancer cell growth. This approach not only improves treatment effectiveness and increases survival rates but also reduces side effects, leading to a better quality of life for patients. For patients with advanced disease, the first treatment they receive shapes their entire journey. Most don’t survive beyond five years on existing treatments, where more than 25% of patients receiving current treatment in 1L do not receive 2L treatment 4 ,5 ,6, which is why starting with the right targeted therapy is essential – it offers the greatest hope and the most time3 that can be spent with loved ones.

We are witnessing a healthcare revolution in this region, where medicine is no longer reactive but targeted to a patient’s needs. 

Public and private sectors must work in tandem to fast-track the integration of advanced clinical tools, expand precision medication education and continue building trust through transparent data governance. 

By taking these decisive steps now, Singapore can accelerate the adoption of precision medicine and set a global benchmark for the future of healthcare. 

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1 Soria, J.-C., Ohe, Y., Vansteenkiste, J., et al. (2017). EGFR-mutated non-small cell lung cancer: a new paradigm for treatment. The Lancet Oncology, 18(8), e493-e507.

2  Tan, S. Y., Lim, S. K., and Wang, L. (2021). Lung cancer in Singapore: trends and patterns. Singapore Medical Journal, 62(6), 294-303.

3 Lin, J. J., Cardarella, S., Lydon, C. A., Dahlberg, S. E., Jackman, D. M., Jänne, P. A., & Johnson, B. E. (2016). Five-Year Survival in EGFR-Mutant Metastatic Lung Adenocarcinoma Treated with EGFR-TKIs. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer, 11(4), 556–565. https://doi.org/10.1016/j.jtho.2015.12.103.

4 Nieva J, et al. Ann Oncol. 2023;34: S774.

5 Girard, N. et al. J Thorac Oncol. 2023;18(4): S51-52.

6 Lee JY, et al. J Thorac Oncol. 2022;17(9): Suppl: S440.