Professor Dato’ Dr. Fuad Ismail graduated from University Kebangsaan Malaysia (UKM) with a MD in the year 1990. He obtained dual Fellowships from the Royal College of Surgeons Ireland and Royal College of Radiologists London in 1996. Prof Fuad currently serves at UKM as a Clinical Associate Professor of Oncology. He supervises and serves as an examiner for postgraduate Oncology students in addition to his regular clinical duties. He is also currently the Head of Department at UKM Oncology & Radiotherapy Department since 1999 and Chairman of the Ethics Committee in UKM since 2010. Prof Fuad has contributed as a Committee Member to various Clinical Practice Guidelines for cancer treatment, and most recently in the Management of Cervical Cancer (2015). He is a Committee Member of the Malaysian Oncological Society (MOS) and has authored 26 publications in peer-reviewed journals. Prof Fuad speaks regularly at scientific symposia and has served as a Faculty Member at more than 114 regional and national conferences. He is also actively involved in community service.
Prof Fuad, you have been involved in many oncology clinical trials at UKM. In your opinion, how can phase 2 and 3 clinical trials help broaden treatment options for doctors and patients in this field?
Many oncologists actually participate in clinical trials to give their patients an additional option for therapy. There is the altruistic motive of developing and improving drug therapy but a big portion is also in expanding drug access through a clinical trial. Therapies considered “standard” in Europe and the US, for example Herceptin, as adjuvant for breast cancer, is not readily available here for our patients due to its cost, but by enrolling them into clinical trials, whether in the metastatic or adjuvant setting, allows them to have access to these standard therapies. These are particularly for Phase 3 trials as it is usually a new drug versus standard therapy. For phase 2 trials the motivation is more towards development of new products (drugs).
Why do you think it is important for the Ministry of Health, institutions and universities to work collaboratively towards developing a complete ecosystem in clinical research?
We need to build capacity to be able to develop our own drugs. This is very ambitious given the complexity of the process and the enormous funding required but we do want to move up the value ladder. It is easier to do later phase trials compared to a Phase 1/2 trial but these are the trials that are at the head of innovation, and eventually we should try to move towards researching and trialing our own products. Having said that, product development would more likely be in collaboration with a major pharmaceutical as partner, if at all possible.
We need to build capacity to be able to develop our own drugs. This is very ambitious given the complexity of the process and the enormous funding required but we do want to move up the value ladder.
In the field of clinical research, where do you wish to see Malaysia in the next 10 years?
I hope we would be able to catch up a bit with Singapore who are now testing out their own products and innovative therapies. We should be doing Phase 1/2 trials routinely and be one of the preferred partners. We would need much more coordination and reduce duplication of work/equipment. To do this, the remuneration must be more attractive as to reduce the need for specialists to conduct many clinics and the senior ones would be able to give directions rather than work as foot soldiers.
How has CRM made a difference in the clinical research ecosystem in Malaysia?
CRM has done a good job coordinating some of the research and taking some burden away from researchers, for example providing Study Coordinators. I would like to see CRM being more coordinated with the various centres (eg. with trial updates, new potential projects etc.). At present I think we are still working in silos and know little about what happens outside our institutions and are only updated in person when we meet at meetings. Perhaps some brainstorming session between different institutions would help and guide people to specialize in certain areas rather than to be in competition. CRM can structure to knit MOH, MOHE and different organizations (eg. CARIF) as long as they remain neutral and not strongly affiliated with a particular Ministry.