SINGAPORE – Facing what was then an incurable cancer in 2022, Alyssa Tapley, then aged 13, became the first person in the world to receive a revolutionary new treatment.
A year earlier, the teenager from Leicestershire in Britain had been diagnosed with T-cell acute lymphoblastic leukaemia (T-ALL) – an aggressive form of blood cancer in which T-cells, a type of white blood cell, become malignant.
Using a technique known as “base editing”, doctors at Great Ormond Street Hospital in London were able to engineer a new type of T-cell that could hunt down and eliminate her cancerous T-cells.
Base editing allows scientists to change a single DNA letter – which are chemicals called nucleotides that make up the genetic code – into another with high precision.
Using a customised protein, base editing damages DNA less than CRISPR – an earlier gene-editing technology – as it nicks only one strand of the two in the double helix through rewriting, whereas CRISPR cuts through both to insert or change a gene.
Having undergone the experimental gene therapy in May 2022, Alyssa remains cancer-free four years later and now hopes to become a cancer scientist herself, the BBC reported.
She is one of the first 11 patients, across the Great Ormond Street and King’s College hospitals in London, to have received the new treatment, dubbed BE-CAR7.
A study published in the New England Journal of Medicine in December found that nine of the 11 had achieved remission, allowing them to undergo a bone marrow transplant, while seven remained disease-free between three months and three years after treatment.
A similar treatment for T-ALL, CD7 CAR T-cell therapy, was developed by the National University of Singapore’s Yong Loo Lin School of Medicine and the National University Health System.
The revolutionary treatment is just one application of biotechnology – an umbrella term for a broad field that combines biology and technology to create products used in healthcare, agriculture, environmental management and other areas.
In healthcare, this includes cell and gene therapies such as chimeric antigen receptor (CAR) T-cell therapy, which allows cancer patients to recover more quickly without the need for aggressive chemotherapy, with longer-lasting remissions.
CAR T-cell therapy is also being studied in the treatment of autoimmune diseases such as myasthenia gravis, a chronic condition that can cause muscle weakness, fatigue and speech impairment.
Meanwhile, the game-changing mRNA technology used to develop Covid-19 vaccines – whereby human cells are taught to make proteins that trigger the immune system to build antibodies – is being studied for cancer vaccines, with clinical trials of personalised mRNA vaccines for melanoma, a type of skin cancer, showing success.
Beyond the medical field, biotechnology also has applications across a wide variety of sectors.
These include agriculture, where CRISPR, which is short for clustered regularly interspaced short palindromic repeats, a technology being used to treat sickle cell disease and certain cancers, is being studied in improving crop yield as well as developing fruit and vegetables that are more resistant to disease and have longer shelf lives.
In other areas, bioengineered yeast and fungi are used to create complex molecules for a range of products, from cosmetics to biofuels, while elsewhere, microbes are employed to break down toxic hydrocarbons during oil spills and synthetic polymers in plastics.
These cutting-edge applications have the global biotechnology market valued at US$1.55 trillion (S$2 trillion) as at 2023, a figure that is expected to grow to US$3.88 trillion by 2030, according to market research firm Grand View Research.
However, the revolutionary potential of biotechnology has also been accompanied by question marks over the ethical implications of its application, such as in the creation of “designer babies”.
In 2019, Chinese biophysicist He Jiankui was sentenced to three years in prison and fined 3 million yuan (S$570,000) for illegal practice of medicine after using CRISPR to create the first genetically edited human babies – twin girls who were born modified with HIV resistance.
He was criticised for violating ethical norms and exposing the babies to risks associated with gene editing.
In June, researchers from Columbia University said they had edited the DNA of human embryos using base editing.
In a preprint – a research paper that has not yet undergone peer review – the researchers detailed how they inserted genetic mutations into newly fertilised eggs or single-cell embryos, altering genes that regulate cholesterol and encode foetal haemoglobin.
Their work was lauded for advancing research to address disease-causing mutations in embryos, but also drew criticism as a first step towards creating humans with desired traits.
In agriculture, concerns have been raised about the safety of gene-edited crops, including whether the process could lead to unintended consequences for plants or reduce the natural diversity of plant genetics.
Adding to the ethical minefield, artificial intelligence tools are transforming drug development by accelerating protein design and production, a process that was previously lengthy and involved much trial and error.
At the University of Cambridge, for instance, researchers are studying an AI-designed “universal vaccine” that could offer protection against a variety of viruses, including influenza, various coronaviruses, and Ebola, even as they evolve.
While this is to be welcomed, such capabilities can also give rise to “dual-use research of concern”, where that which is intended to provide benefit could be misapplied to cause harm.
The relatively low barriers to entry of using AI tools to design proteins could be leveraged by bad actors to create biological weapons or make existing pathogens deadlier and more transmissible.
A study by tech giant Microsoft, published in the peer-reviewed journal Science in October 2025, found that synthetic toxins generated by widely available AI protein-design tools could indeed evade existing screening measures.
Despite these concerns, over the past year, several start-ups have announced plans to research safely creating genetically edited babies.
They include San Francisco-based Preventive, which said it had raised US$30 million to study heritable genome editing, in which embryos’ DNA would be modified to correct harmful mutations or introduce beneficial genes to prevent disease.
So what guardrails exist to prevent bad actors from exploiting biotechnology and provide assurances of its ethical use, while also ensuring the technologies’ revolutionary potential is not stifled?
In a July 2025 paper for the journal mSphere, a past president of ABSA International – a non-profit professional organisation dedicated to biosafety and biosecurity – writing about the US bioeconomy said that biosecurity governance “must move away from rigid, top-down models and move to adaptive, risk-tiered systems that integrate institutional expertise, tacit knowledge of biosafety professionals and compliance personnel, along with scientists”.
Having safeguards at multiple points and levels would better deal with the dynamic nature of the biotechnology research enterprise, said David Gillum, who noted: “Such reform is possible and necessary to safeguard public health and scientific progress in an increasingly complex landscape.”
While governments and regulators in many countries have established rules governing the sector, the scientific community and corporations know they need to get ahead of the issues.
Institutional review boards at research institutions ensure research adheres to ethical guidelines, while scientific journals require authors to disclose potential biosecurity risks and dual-use implications of the research before publication.
Meanwhile, as part of its Paraphrase Project, Microsoft developed biosecurity techniques to address the vulnerabilities it had identified as introduced by AI protein-design tools.
At present, global consensus has coalesced around limiting gene editing to somatic cells – mainly in the treatment of disease in individuals – while banning or severely restricting germline editing, or the altering of DNA in embryos, egg and sperm cells, which can be passed on to later generations.
Several countries have already introduced laws strictly regulating gene editing. These include China, where after the controversy surrounding He Jiankui’s case, clinical research and implantation of edited embryos were banned.
And in April, Japan introduced a Bill that would outlaw research and treatments involving the genetic modification of human fertilised eggs using genome editing technology.
Yet, this is not to suggest that governments want to suppress innovation in the field.
Earlier in 2026, the US Food and Drug Administration proposed a new framework to accelerate approvals of personalised treatments for rare genetic diseases and, in draft guidance issued in June, proposed allowing manufacturers of cell and gene therapies for rare, life-threatening diseases to use existing scientific knowledge to expedite development.
In her book A Crack In Creation: A Nobel Prize Winner’s Insight Into The Future Of Genetic Engineering, American biochemist Jennifer Doudna wrote: “The power to control our species’ genetic future is awesome and terrifying.
“Deciding how to handle it may be the biggest challenge we have ever faced,” said the co-winner of the 2020 Nobel Prize in Chemistry for her pioneering work on CRISPR gene editing.
Even as Singapore’s biotechnology – and in particular biomedical sciences – sector continues to grow, the country remains mindful of ethical and safety considerations.
The Republic launched its biomedical sciences initiative in 2000, and today, it contributes 1.9 per cent of Singapore’s gross domestic product, with the industry producing more than $32 billion worth of products in 2024, according to data from the Economic Development Board.
Beyond economic benefit, this focus on biomedical sciences has translated into practical healthcare benefits for its population.
Under Singapore’s Research, Innovation and Enterprise 2025 plan, the National Precision Medicine programme now contains the whole-genome sequences of more than 100,000 people here – one of the largest genomic databases for multi-ethnic Asian cohorts.
The programme’s findings in the early detection of familial hypercholesterolaemia – a genetic disorder that causes dangerously high levels of LDL cholesterol from birth – were instrumental in the introduction of a genetic testing programme for the condition in June 2025.
This could allow for earlier interventions, reducing the risk of premature heart disease.
At the inaugural Asian Bioethics Network Conference in October 2025, director-general of health Kenneth Mak said developments in AI, precision medicine, gene editing, and innovations in human longevity were bringing humans closer to what was once unimaginable – cures for hereditary diseases and extended healthy lifespans.
But it also meant Singapore must continue to evolve its approaches to keep up with the developments, he noted.
“Precision medicine promises accelerated diagnoses and targeted prevention but also challenges us to manage data disclosure and confidentiality,” Mak said.
“Healthcare providers must navigate whether, when, and how to disclose genetic information, especially when variants of uncertain significance may only gain clinical meaning in the future.”
Singapore’s Bioethics Advisory Committee also said then that heritable gene editing is not recommended for clinical research or application in Singapore, and called for full validation of the technology’s safety and efficacy.
It noted that unintended edits introduced during genetic modifications could be passed down to future generations.
The committee’s recommendations were included in an advisory publication on the ethical use of human nuclear genome editing for technologies in biomedical research and clinical applications.
The Republic’s Ministry of Health has not approved heritable gene editing due to insufficient evidence of its safety.
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