From Bedside to Bench: A Cardiologist's Journey into Precision Genomics

26 January 2025

In the rapidly evolving landscape of modern medicine, the intersection of cardiology and oncology represents one of healthcare's most significant challenges. Cardiovascular disease is now the leading cause of mortality among cancer survivors worldwide, claiming over 370,000 lives annually. For Dr. Jun Hua Chong, an established cardiologist consultant with years of clinical practice and expertise, this statistic wasn't just a number — it was a call to action that prompted her to expand her knowledge beyond traditional clinical boundaries.

"As a clinician in ethnically-diverse Singapore, I was keen to understand the varied genomic underpinnings of disease across the various ethnicities and cultures, and to equip myself with an understanding of precision medicine concepts that would translate into personalised health insights for my patients."

This motivation led Dr. Chong to enroll in PHM5001 — Human Genomics in Precision Medicine, a core module in the Master of Science in Precision Health and Medicine programme at NUS.

From Classroom to Publication

What began as coursework transformed into something far more significant. Dr. Chong, along with collaborators including Prof. Lee herself, authored a review article titled "Revolutionising Cardio-Oncology Care with Precision Genomics," recently published in the International Journal of Molecular Sciences.

Bridging Clinical Specialties Through Genomics

The paper elegantly bridges two complex specialties—cardiology and oncology—through the lens of precision genomics. It explores how genetic testing and advanced genomic approaches can help clinicians better assess risk, diagnose conditions, and deliver personalized therapeutics.

Through detailed analysis of three key use cases—Cancer Therapy-Related Cardiac Dysfunction (CTRCD), Clonal Haematopoiesis of Indeterminate Potential (CHIP), and Polygenic Risk Scoring—the publication provides a roadmap for clinicians looking to incorporate precision medicine into cardio-oncology practice.

"What's remarkable about this work," adds program director Prof. Lee, "is how Dr. Chong translated complex genomic concepts into actionable clinical insights. This exemplifies exactly what our program aims to achieve—equipping healthcare professionals with the knowledge to bridge the gap between cutting-edge science and patient care."

From Course Content to Clinical Impact

The paper highlights several breakthrough approaches that have immediate clinical applications:

• Identification of genetic variants (like rs1786814 in CELF4 and rs2229774 in RARG) that increase risk of anthracycline-induced cardiotoxicity, allowing for personalized risk stratification before cancer treatment
• Recognition of Clonal hematopoiesis of indeterminate potential (CHIP) as an independent risk factor for cardiovascular disease, offering new opportunities for targeted interventions
• Implementation of polygenic risk scoring to identify high-risk cancer survivors who might benefit from more aggressive preventive strategies
• Utilization of long non-coding RNAs and microRNAs as potential biomarkers for cancer drug-induced cardiotoxicity
• Application of human-induced pluripotent stem cells (hiPSCs) for modeling individual patients' risk profiles

A New Generation of Precision Medicine Leaders

The publication represents more than academic achievement—it signals a shift in how clinicians can approach complex medical challenges. By incorporating precision genomics into established clinical entities, Dr. Chong's work demonstrates how the future of medicine will increasingly rely on individualized approaches.

Dr. Chong offers advice for clinicians considering similar educational paths: "I would recommend incoming students to make the most of the group project opportunities to network and learn from each other. Prof Caroline and faculty are always very supportive of any questions we may have as a group, and they constantly pique our interest in our presentation topics."

As medicine continues to evolve toward more precise, personalized approaches, programmes like the Master's in Precision Health and Medicine are positioning themselves as essential training grounds for the healthcare leaders of tomorrow—clinicians who can translate complex genomic insights into better care for our most vulnerable patients.