Fighting cancer, one discovery at a time

For most students, the Final Year Project (FYP) is the culmination of years of study. For Raegan Sim (Life Sciences, Class of 2025), it became the work that propelled her onto the global stage - one that stemmed from a deeply personal journey inspired by her grandfather, who passed away from cancer. Her research on cancer and its resistance to chemotherapy was recognised with the Global Winner award and the prestigious Thomas Clarkson Gold Medal at the Global Undergraduate Awards, distinguishing her as the only NUS student to achieve this international honour in 2025.

How did you feel when you first heard the news?

I was in complete disbelief. I had hoped to earn a Highly Commended Award, which recognises the top 10 percent of submissions. To instead be named the global winner was far beyond anything I had imagined and it was truly surreal! I am deeply honoured that the judges appreciated my work and chose to recognise it in such a meaningful way.

What does this recognition mean to you? How do you think it will influence your future academic or career journey?

This means everything to me. My FYP thesis was the result of countless late nights, experiments conducted during any free time available and weekends spent thesis writing instead of socialising. This award affirmed that all the sacrifices were worthwhile. More importantly, it demonstrated the global relevance of my research area.

My work explores relatively new but increasingly important topics in cancer biology and knowing that it resonated with leading academics worldwide is reinvigorating! I am currently exploring a future in biomedical research, particularly in cancer research; this recognition has strengthened my confidence in pursuing that path.

What were some memorable moments participating in the Awards?

I am very much looking forward to meeting the other global winners and the judges in person at the Global Undergraduate Awards (GUA) Global Summit in November.  I hope to build meaningful connections with individuals who share similar passions, whether that leads to future collaborations or simply lasting friendships.

This will be my first time attending a conference and presenting in front of such an accomplished audience. As the only NUS student to receive this honour, I am deeply grateful for the opportunity to represent both NUS and Singapore on the global stage. Although I anticipate feeling nervous, I intend to approach the experience with humility and confidence and to deliver my presentation to the best of my ability. I hope to do both NUS and Singapore proud.

Can you describe your work? What inspired you to study ovarian cancer and specifically, the mechanisms of chemotherapy resistance?

My study investigates how a rare type of giant cancer cell, known as a poly-aneuploid cancer cell (PACC), transfers mitochondria - the “powerhouse” of the cell - to smaller neighbouring cancer cells. By sharing these highly efficient mitochondria, the giant cells essentially “turbocharge” their neighbours, helping them withstand the stress of chemotherapy and increasing their resistance to treatment.

Ovarian cancer is associated with poor survival rates, largely due to late-stage diagnosis and limited response to chemotherapy. However, the cancer cell survival strategies we study, such as mitochondrial transfer, are not unique to ovarian cancer - they are also observed in other cancers such as breast, colorectal and lung cancers. By uncovering how cancer cells adapt to evade treatment, we hope to identify new therapeutic strategies that could improve outcomes across multiple cancer types.

On a personal note, I lost my grandfather to cancer in 2018. When he stopped responding to chemotherapy, there was little more medicine could do for him. That experience motivated me to study cancer and contribute, in whatever way I can, to developing more effective treatments. While curing cancer remains an enormous challenge, each discovery brings us a step closer to improving outcomes for patients and supporting families affected by this disease worldwide.

What were the biggest challenges you faced while working on this project, and how did you overcome them?

The biggest lessons I took away from this project were resilience, patience and diligent planning. One of the main challenges I faced was managing time effectively. Many experiments spanned several days and time was often not on my side. To stay on track, I planned my experiments carefully and ran multiple experiments concurrently whenever possible. This required foresight, organisation and strategic scheduling to make the most of my time in the lab.

Another challenge was mastering complex experimental techniques. Learning these procedures took time, but I was fortunate to have supportive and patient mentors from the NUS Yong Loo Lin School of Medicine (NUS Medicine) who guided me throughout the process. To ensure I could execute experiments accurately, I maintained detailed notes of each protocol, which allowed me to recall them easily the next time I needed to perform the same experiment.

Despite the occasional moments of being overwhelmed, I reminded myself that “you reap what you sow” and persevered, drawing support from close friends and family when needed. These experiences taught me not only practical laboratory skills, but also the importance of planning, persistence and leveraging mentorship to overcome challenges in research.

Were there any surprising or breakthrough findings during your journey?

Yes. Cancer cells always seem to be one step ahead of medicine. During my FYP, we discovered that PACCs are able to survive under extreme conditions, including low oxygen levels, unfavourable temperatures and even high doses of chemotherapy. While some of these survival strategies have been documented in the literature, it was still striking to witness firsthand how resilient these cells are. It underscores how much more work is needed to effectively target them.

Another interesting finding was the mechanism of mitochondrial transfer between PACCs and their neighbouring cells. We found that PACCs transfer mitochondria to their neighbouring cells via tunnelling nanotubes (TNTs), which act as cellular “highways” connecting one cell to another. Using confocal microscopy, we were able to observe this transfer directly. This discovery is significant because one of our strategies to target PACCs involves inhibiting TNT formation, effectively blocking the transfer of mitochondria from PACCs and thus preventing neighbouring cells from gaining increased chemoresistance.

We also observed that the mitochondria in PACCs have a distinct morphology compared to those in normal or other cancer cells. In layman’s terms, these mitochondria are more efficient at generating energy, which supports the PACC’s survival and thrive under harsh conditions and allows them to “supercharge” neighbouring cells through mitochondrial transfer.

How could your findings potentially shape future cancer treatments or clinical approaches?

My work has implications that extend beyond ovarian cancer. Similar PACC behaviours, including mitochondrial transfer, have been observed in breast, colorectal and lung cancers. Understanding how PACCs survive, how they transfer mitochondria and how their morphology supports this survival is crucial for developing new strategies to target them. Standard chemotherapy agents are largely ineffective against PACCs, so alternative approaches are needed. We are currently exploring ways to target their survival mechanisms or their mitochondrial transfer pathways, with the potential to adapt strategies as we learn more. These findings could be pivotal in treating patients with chemoresistant cancers.

Additionally, understanding how these mitochondria become “super-charged” could have applications beyond cancer. For example, harnessing such efficient mitochondria could improve tissue regeneration, potentially accelerating repair in highly damaged tissues. This dual potential - both in targeting chemoresistant cancer cells and exploring regenerative applications - highlights the broader impact of this research.

How did your studies prepare you for undertaking such a challenging project?

My coursework and research opportunities at the Faculty of Science gave me a strong foundation for tackling this challenging project. The rigorous curriculum helped me build critical thinking and problem-solving skills, and gave me a solid understanding of molecular, cellular and cancer biology - all of which were essential for designing and interpreting my experiments.

Any plans to take the project further?

Yes, definitely. Our laboratory will be submitting a paper for publication in the coming months. My FYP thesis provides a strong foundation for this work, which will expand our research beyond ovarian cancer to include breast, colorectal and lung cancers. The paper will build on the findings from my thesis and explore potential therapeutic strategies aimed at improving outcomes for patients with PACC subtypes.