Komathi Perumal

@seabioethics.com

Project Manager, SEA Bioethics Network, Faculty of Law
Universiti Malaya

Komathi Perumal


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https://researchid.co/pkomathi

RESEARCH, TEACHING, or OTHER INTERESTS

Multidisciplinary, Molecular Biology, Law, Social Sciences
10

Scopus Publications

143

Scholar Citations

7

Scholar h-index

6

Scholar i10-index

Scopus Publications

  • Prevalence and treatment of human epidermal growth factor receptor 2-altered non-small cell lung cancer: a retrospective analysis and systematic literature review
    Ning Yi Yap, Komathi Perumal, Pathmanathan Rajadurai
    Ecancermedicalscience, 2024
    Human epidermal growth factor receptor 2 (HER2) is known for its oncogenic activities in diverse cancers, including non-small cell lung cancer (NSCLC). However, the prevalence of HER2 alterations in Malaysian NSCLC patients remains unreported. This study examined the prevalence and characteristics of HER2 mutations and amplification in a Malaysian cohort. Additionally, a systematic review was conducted to evaluate the global prevalence of HER2 alterations in NSCLC, as well as the efficacy of HER2-targeted therapies observed in clinical trials. NSCLC tumour samples received from October 2019 to December 2022 for next-generation sequencing diagnostics were included in the retrospective analysis. In this patient cohort, HER2 alteration was present in 5.8% of patients; 3.9% had HER2 mutations, 1.5% had HER2 amplifications and 0.4% were both HER2-mutated and amplified. HER2 exon 20 insertions were the most common HER2 variants, detected in 47/59 (79.7%) of HER2-mutated patients. Among cases with HER2 exon 20 insertions, the Y772_A775dup variant was found in 34 patient samples. HER2-mutated patients were significantly younger than non-HER2-mutants (61 versus 64 years old; p = 0.046) and were inclined to be female and never-smokers, albeit not statistically significant. Patients with HER2 amplification were more likely to have progressed post-tyrosine kinase inhibitor therapy (p = 0.015). The systematic review highlighted a global variation in the prevalence of HER2 alterations in NSCLC, ranging from 0.3% to 9.1% for mutations and 0.2% to 19% for amplification. Finally, phase II clinical trials involving HER2-altered NSCLC patients demonstrated promising treatment outcomes with trastuzumab deruxtecan, trastuzumab emtansine, pyrotinib, pyrotinib + apatinib and trastuzumab + pertuzumab + docetaxel. In conclusion, the prevalence of HER2 alteration among Malaysian NSCLC patients falls within the global range. A systematic review of clinical trials revealed promising treatment outcomes and Malaysian NSCLC patients with HER2 alterations are anticipated to similarly benefit from HER2-targeted therapies.
  • Potential Value of Visfatin, Omentin-1, Nesfatin-1 and Apelin in Renal Cell Carcinoma (RCC): A Systematic Review and Meta-Analysis
    Sugania Malar Chinapayan, Shanggar Kuppusamy, Ning Yi Yap, Komathi Perumal, Glenda Gobe, Retnagowri Rajandram
    Diagnostics, 2022
    Renal cell carcinoma (RCC) is the most lethal genitourinary malignancy. Obesity is a risk factor for RCC development. The role of adipokines in the relationship between obesity and RCC requires confirmatory evidence in the form of a systematic review and meta-analysis, specifically for visfatin, omentin-1, nesfatin-1 and apelin. A search of databases up to July 2022 (PubMed, Web of Science and Scopus) for studies reporting the association of these selected adipokines with RCC was conducted. A total of 13 studies fulfilled the selection criteria. Only visfatin (p < 0.05) and nesfatin-1 (p < 0.05) had a significant association with RCC. Meanwhile, apelin and omentin-1 showed no association with RCC. The meta-analysis results of nesfatin-1 showed no association with early-stage (OR = 0.09, 95% CI = −0.12–0.29, p = 0.41), late-stage (OR = 0.36, 95% CI = 0.07–1.89, p = 0.23) and low-grade (OR = 1.75, 95% CI = 0.37–8.27, p = 0.48) RCC. However, nesfatin-1 showed an association with a high grade of the disease (OR = 0.29, 95% CI = 0.13–0.61, p = 0.001) and poorer overall survival (OS) (HR = 3.86, 95% CI = 2.18–6.85; p < 0.01). Apelin showed no association with the risk of RCC development (mean difference = 21.15, 95% CI = −23.69–65.99, p = 0.36) and OS (HR = 1.04, 95% Cl = 0.45–2.41; p = 0.92). Although the number of studies evaluated was limited, analysis from this systematic review and meta-analysis indicate that visfatin and nesfatin-1 were elevated. In summary, these adipokines may play a role in the development and progression of RCC and hence may have potential diagnostic and prognostic capabilities for RCC.
  • Nanoparticles and Gut Microbiota in Colorectal Cancer
    Komathi Perumal, Suhana Ahmad, Manali Haniti Mohd-Zahid, Wan Nurhidayah Wan Hanaffi, Iskander Z.A., Jean-Luc Six, Khalid Ferji, Juhana Jaafar, Jennifer C. Boer, Magdalena Plebanski, Vuk Uskoković, Rohimah Mohamud
    Frontiers in Nanotechnology, 2021
    Recent years have witnessed an unprecedented growth in the research area of nanomedicine. There is an increasing optimism that nanotechnology applied to medicine will bring significant advances in the diagnosis and treatment of various diseases, including colorectal cancer (CRC), a type of neoplasm affecting cells in the colon or the rectum. Recent findings suggest that the role of microbiota is crucial in the development of CRC and its progression. Dysbiosis is a condition that disturbs the normal microbial environment in the gut and is often observed in CRC patients. In order to detect and treat precancerous lesions, new tools such as nanotechnology-based theranostics, provide a promising option for targeted marker detection or therapy for CRC. Because the presence of gut microbiota influences the route of biomarker detection and the route of the interaction of nanoparticle/drug complexes with target cells, the development of nanoparticles with appropriate sizes, morphologies, chemical compositions and concentrations might overcome this fundamental barrier. Metallic particles are good candidates for nanoparticle-induced intestinal dysbiosis, but this aspect has been poorly explored to date. Herein, we focus on reviewing and discussing nanotechnologies with potential applications in CRC through the involvement of gut microbiota and highlight the clinical areas that would benefit from these new medical technologies.
  • Cancer Nanomedicine and Immune System—Interactions and Challenges
    Suhana Ahmad, Ros Akmal Mohd Idris, Wan Nurhidayah Wan Hanaffi, Komathi Perumal, Jennifer C. Boer, Magdalena Plebanski, Juhana Jaafar, Jit Kang Lim, Rohimah Mohamud
    Frontiers in Nanotechnology, 2021
    Nanoparticles have tremendous therapeutic potential in the treatment of cancer as they increase drug delivery, attenuate drug toxicity, and protect drugs from rapid clearance. Since Doxil®, the first FDA-approved nanomedicine, several other cancer nanomedicines have been approved and have successfully increased the efficacy over their free drug counterparts. Although their mechanisms of action are well established, their effects towards our immune system, particularly in the tumor microenvironment (TME), still warrant further investigation. Herein, we review the interactions between an approved cancer nanomedicine with TME immunology. We also discuss the challenges that need to be addressed for the full clinical potential of ongoing cancer nanomedicines despite the encouraging preclinical data.
  • A Study on the Immunohistochemical Expressions of Leptin and Leptin Receptor in Clear Cell Renal Cell Carcinoma
    Komathi Perumal, Kein Seong Mun, Ning Yi Yap, Azad Hassan Abdul Razack, Glenda Carolyn Gobe, Teng Aik Ong, Shanggar Kuppusamy, Retnagowri Rajandram
    Biomed Research International, 2020
    Background. The mechanisms that link obesity and cancer development are not well-defined. Investigation of leptin and leptin receptor expressions may help define some of the mechanisms. These proteins are known for associating with the immune response, angiogenesis and, signalling pathways such as JAK2/STAT3, PI3K, and AKT pathways. Tissue proteins can be easily detected with immunohistochemistry (IHC), a technique widely used both in diagnostic and research laboratories. The identification of altered levels of leptin and leptin receptor proteins in tumour tissues may lead to targeted treatment for cancer. Objective. The objective of this study was to use IHC to compare leptin and leptin receptor expressions in clear cell renal cell carcinomas (ccRCC) in non-obese and obese patients to determine the association between these proteins with the clinicopathological features and prognosis of ccRCC. Patients and Methods. The study involved 60 patients who underwent nephrectomy of which 34 were obese, as assessed using body mass index (BMI). Nephrectomy samples provided tissues of ccRCC and adjacent non-cancerous kidney. The intensity and localization of leptin and leptin receptor protein expressions were evaluated using IHC and correlated with clinicopathological features and clinical outcomes. Aperio ImageScope morphometry and digital pathology were applied to assess the IHC results. The chi-square test was used to determine if there was any significant association between the proteins and the clinicopathological features. The Kaplan-Meier test was used to determine the overall survival, disease-free survival, and recurrence-free survival. A value of p<0.05 was considered significant. Results. There was neither significant difference in the overall cellular and nuclear expressions of leptin and leptin receptor between non-cancerous kidney and ccRCC tissues nor in non-obese and obese individuals with ccRCC. Conclusion. In this present study, it was revealed that leptin and leptin receptor were not associated with tumour characteristics and progression of ccRCC patients. Interestingly, nuclear expression of leptin was significantly associated with overall survival. However, the significance of these proteins as biomarkers in other RCC histotypes is still unclear.
  • Corrigendum to “Role of leptin as a biomarker for early detection of renal cell carcinoma? No evidence from a systematic review and meta-analysis” (Medical Hypotheses (2019) 129, (S0306987719301100), (10.1016/j.mehy.2019.109239))
    Komathi Perumal, Weng Kit Huin, Ning Yi Yap, Teng Aik Ong, Glenda Carolyn Gobe, Retnagowri Rajandram
    Medical Hypotheses, 2019
  • Circulating adiponectin as a biomarker in renal cell carcinoma: a systematic review and meta-analysis
    Ning Yi Yap, Foo Ngan Yap, Komathi Perumal, Retnagowri Rajandram
    Biomarkers, 2019
    Context: Metabolic imbalance in renal cell carcinoma (RCC) can lead to abnormal adiponectin levels. Objective: To evaluate circulating adiponectin as a detection or predictive marker for RCC. Methods: A comprehensive literature search and meta-analysis was performed on studies reporting circulating adiponectin levels and RCC. The meta-analysis was performed using RevMan. Results: Seven studies compared the circulating adiponection levels between RCC cases and controls. Adiponectin level was significantly lower in RCC cases compared to controls at pre-diagnosis and pre-operative time-points. RCC stage, grade and subtype did not affect adiponectin levels. Conclusion: Low circulating adiponectin could be a predictive or risk factor for RCC.
  • Role of leptin as a biomarker for early detection of renal cell carcinoma? No evidence from a systematic review and meta-analysis
    Komathi Perumal, Weng Kit Huin, Ning Yi Yap, Teng Aik Ong, Glenda Carolyn Gobe, Retnagowri Rajandram
    Medical Hypotheses, 2019
  • Prognostic biomarkers in renal cell carcinoma: Is there a relationship with obesity?
    Retnagowri Rajandram, Komathi Perumal, Ning Yi Yap
    Translational Andrology and Urology, 2019
    Obesity is a recognized risk factor for renal cell carcinoma (RCC) the commonest form of kidney cancer. Both obesity and RCC are serious diseases with increasing incidence yearly. This review examined certain obesity associated measurements and adipokines as detection/prognostic indicators for RCC. The obesity related measurements such as body mass index (BMI), waist circumstance (WC), waist-hip ratio (WHR) in predicting RCC are valid when used in conjunction with other risk factors such as age and sex or with histological findings. The adipokine adiponectin holds promising outcomes as a predictive marker in assessing the risk of developing RCC. In addition, tissue leptin/leptin receptor may be a distinguishing marker for RCC subtypes. However, circulating leptin may not be a suitable detection or prognostic biomarker for RCC. The other less investigated adipokines; omentin, visfatin, apelin and resistin are also expressed in RCC but their prognostic capabilities are still inconclusive. BMI, WC and adipokines may be useful additions in a nomogram which includes TNM staging and pathological grading system to detect, confirm and follow-up RCC cases.
  • Practical updates in medical therapy for advanced and metastatic renal cell carcinoma
    Ning Yi Yap, Wan Thien Khoo, Komathi Perumal, Kar Aik Ng, Retnagowri Rajandram, Adlinda Alip, Marniza Saad, Teng Aik Ong
    Urological Science, 2018
    The evolution of therapy for advanced or metastatic renal cell carcinoma (RCC) progressed over the past decade from using cytokine immunotherapy to targeted therapy which predominantly inhibits angiogenesis via the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways. Currently, there are several approved agents in the first-line (e.g. sunitinib, pazopanib, ipilimumab/nivolumab, bevacizumab/IFN-α combination and temsirolimus) and second-line settings (e.g. everolimus, axitinib, sorafenib, cabozantinib, nivolumab and lenvatinib/everolimus combination). These agents are used in sequence upon progression due to drug resistance or intolerable toxicities. The European Association of Urology (EAU), European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network (NCCN) guidelines recommend the use of these agents based on evidence from clinical trials and expert committee consensus. The recent approval of immune checkpoint inhibitors due to the encouraging results from clinical trials has expanded the treatment options for patients with advanced or metastatic RCC. This will hopefully improve the treatment outcomes, reduce toxicities and ameliorate quality of life for these patients.

RECENT SCHOLAR PUBLICATIONS

  • Prevalence and treatment of human epidermal growth factor receptor 2-altered non-small cell lung cancer: a retrospective analysis and systematic literature review
    NY Yap, K Perumal, P Rajadurai
    ecancermedicalscience 18, 1734 , 2024
    2024
    Citations: 1
  • 587P Exploring the prevalence and characteristics of human epidermal growth factor receptor 2 (HER2) alterations in non-small cell lung cancer: Analysis from a Malaysian cohort
    NY Yap, K Perumal, P Rajadurai
    Annals of Oncology 34, S1699-S1700 , 2023
    2023
  • Potential value of visfatin, omentin-1, nesfatin-1 and apelin in renal cell carcinoma (RCC): a systematic review and meta-analysis
    SM Chinapayan, S Kuppusamy, NY Yap, K Perumal, G Gobe, ...
    Diagnostics 12 (12), 3069 , 2022
    2022
    Citations: 17
  • A review of visfatin, omentin-1, nesfatin-1 and apelin as a potential biomarker in renal cell carcinoma (RCC)
    SM Chinapayan, S Kuppusamy, NY Yap, K Perumal, G Gobe, ...
    BJU INTERNATIONAL 130, 11-12 , 2022
    2022
  • Nanoparticles and gut microbiota in colorectal cancer
    K Perumal, S Ahmad, MH Mohd-Zahid, WN Wan Hanaffi, I ZA, JL Six, ...
    Frontiers in Nanotechnology 3, 681760 , 2021
    2021
    Citations: 15
  • Cancer nanomedicine and immune system—Interactions and challenges
    S Ahmad, RAM Idris, WN Wan Hanaffi, K Perumal, JC Boer, M Plebanski, ...
    Frontiers in Nanotechnology 3, 681305 , 2021
    2021
    Citations: 23
  • A study on the immunohistochemical expressions of leptin and leptin receptor in clear cell renal cell carcinoma
    K Perumal, KS Mun, NY Yap, AHA Razack, GC Gobe, TA Ong, ...
    BioMed Research International 2020 (1), 3682086 , 2020
    2020
    Citations: 15
  • Circulating adiponectin as a biomarker in renal cell carcinoma: a systematic review and meta-analysis
    NY Yap, FN Yap, K Perumal, R Rajandram
    Biomarkers 24 (6), 607-614 , 2019
    2019
    Citations: 9
  • Role of leptin as a biomarker for early detection of renal cell carcinoma? No evidence from a systematic review and meta-analysis
    K Perumal, WK Huin, NY Yap, TA Ong, GC Gobe, R Rajandram
    Medical Hypotheses 129, 109239 , 2019
    2019
    Citations: 4
  • Prognostic biomarkers in renal cell carcinoma: is there a relationship with obesity?
    R Rajandram, K Perumal, NY Yap
    Translational andrology and urology 8 (Suppl 2), S138 , 2019
    2019
    Citations: 21
  • An exploration of leptin and leptin receptor protein expressions in clear cell renal cell carcinoma tissue and their association with obesity
    K Perumal, K Mun, N Yap, AA Razack, S Kuppusamy, G Gobe, T Ong, ...
    BJU International 123, 79-80 , 2019
    2019
  • Adiponectin as a prediction marker in renal cell carcinoma-a meta-analysis study
    N Yap, F Yap, K Perumal, R Rajandram
    BJU INTERNATIONAL 123, 80-80 , 2019
    2019
  • Association between obesity and renal cell carcinoma: A single centre retrospective study
    YX Foong, NY Yap, K Perumal, R Rajandram, TA Ong
    BJU INTERNATIONAL 122, 30-30 , 2018
    2018
  • A meta-analysis of adiponectin as a prediction marker in renal cell carcinoma
    NY Yap, FN Yap, K Perumal, R Rajandram
    BJU INTERNATIONAL 122, 12-12 , 2018
    2018
  • Practical updates in medical therapy for advanced and metastatic renal cell carcinoma
    NY Yap, WT Khoo, K Perumal, KA Ng, R Rajandram, A Alip, M Saad, ...
    Urological Science 29 (3), 120-128 , 2018
    2018
    Citations: 1
  • The evaluation of Leptin as an appropriate biomarker for the early detection of renal cell carcinoma (RCC): A systematic review and meta-analysis
    K Perumal, WK Huin, NY Yap, TA Ong, GC Gobe, R Rajandram
    BJU International 122, 13-13 , 2018
    2018
  • Plasma homocysteine level and carotid intima–media thickness in type 2 diabetic patients
    KK Perumal, K Santha, S Sethupathy, S Sethurajan, KB Mahendran, ...
    International Journal of Medical Science and Public Health 4 (10), 1404 , 2015
    2015
    Citations: 1
  • Evaluation of wound healing activity of Piper betle leaves and stem extract in experimental Wistar rats
    KC Nilugal, K Perumal, RE Ugander, AI Chittor
    Am. J. PharmTech Res 4 (3), 276-289 , 2014
    2014
    Citations: 36

MOST CITED SCHOLAR PUBLICATIONS

  • Evaluation of wound healing activity of Piper betle leaves and stem extract in experimental Wistar rats
    KC Nilugal, K Perumal, RE Ugander, AI Chittor
    Am. J. PharmTech Res 4 (3), 276-289 , 2014
    2014
    Citations: 36
  • Cancer nanomedicine and immune system—Interactions and challenges
    S Ahmad, RAM Idris, WN Wan Hanaffi, K Perumal, JC Boer, M Plebanski, ...
    Frontiers in Nanotechnology 3, 681305 , 2021
    2021
    Citations: 23
  • Prognostic biomarkers in renal cell carcinoma: is there a relationship with obesity?
    R Rajandram, K Perumal, NY Yap
    Translational andrology and urology 8 (Suppl 2), S138 , 2019
    2019
    Citations: 21
  • Potential value of visfatin, omentin-1, nesfatin-1 and apelin in renal cell carcinoma (RCC): a systematic review and meta-analysis
    SM Chinapayan, S Kuppusamy, NY Yap, K Perumal, G Gobe, ...
    Diagnostics 12 (12), 3069 , 2022
    2022
    Citations: 17
  • Nanoparticles and gut microbiota in colorectal cancer
    K Perumal, S Ahmad, MH Mohd-Zahid, WN Wan Hanaffi, I ZA, JL Six, ...
    Frontiers in Nanotechnology 3, 681760 , 2021
    2021
    Citations: 15
  • A study on the immunohistochemical expressions of leptin and leptin receptor in clear cell renal cell carcinoma
    K Perumal, KS Mun, NY Yap, AHA Razack, GC Gobe, TA Ong, ...
    BioMed Research International 2020 (1), 3682086 , 2020
    2020
    Citations: 15
  • Circulating adiponectin as a biomarker in renal cell carcinoma: a systematic review and meta-analysis
    NY Yap, FN Yap, K Perumal, R Rajandram
    Biomarkers 24 (6), 607-614 , 2019
    2019
    Citations: 9
  • Role of leptin as a biomarker for early detection of renal cell carcinoma? No evidence from a systematic review and meta-analysis
    K Perumal, WK Huin, NY Yap, TA Ong, GC Gobe, R Rajandram
    Medical Hypotheses 129, 109239 , 2019
    2019
    Citations: 4
  • Prevalence and treatment of human epidermal growth factor receptor 2-altered non-small cell lung cancer: a retrospective analysis and systematic literature review
    NY Yap, K Perumal, P Rajadurai
    ecancermedicalscience 18, 1734 , 2024
    2024
    Citations: 1
  • Practical updates in medical therapy for advanced and metastatic renal cell carcinoma
    NY Yap, WT Khoo, K Perumal, KA Ng, R Rajandram, A Alip, M Saad, ...
    Urological Science 29 (3), 120-128 , 2018
    2018
    Citations: 1
  • Plasma homocysteine level and carotid intima–media thickness in type 2 diabetic patients
    KK Perumal, K Santha, S Sethupathy, S Sethurajan, KB Mahendran, ...
    International Journal of Medical Science and Public Health 4 (10), 1404 , 2015
    2015
    Citations: 1
  • 587P Exploring the prevalence and characteristics of human epidermal growth factor receptor 2 (HER2) alterations in non-small cell lung cancer: Analysis from a Malaysian cohort
    NY Yap, K Perumal, P Rajadurai
    Annals of Oncology 34, S1699-S1700 , 2023
    2023
  • A review of visfatin, omentin-1, nesfatin-1 and apelin as a potential biomarker in renal cell carcinoma (RCC)
    SM Chinapayan, S Kuppusamy, NY Yap, K Perumal, G Gobe, ...
    BJU INTERNATIONAL 130, 11-12 , 2022
    2022
  • An exploration of leptin and leptin receptor protein expressions in clear cell renal cell carcinoma tissue and their association with obesity
    K Perumal, K Mun, N Yap, AA Razack, S Kuppusamy, G Gobe, T Ong, ...
    BJU International 123, 79-80 , 2019
    2019
  • Adiponectin as a prediction marker in renal cell carcinoma-a meta-analysis study
    N Yap, F Yap, K Perumal, R Rajandram
    BJU INTERNATIONAL 123, 80-80 , 2019
    2019
  • Association between obesity and renal cell carcinoma: A single centre retrospective study
    YX Foong, NY Yap, K Perumal, R Rajandram, TA Ong
    BJU INTERNATIONAL 122, 30-30 , 2018
    2018
  • A meta-analysis of adiponectin as a prediction marker in renal cell carcinoma
    NY Yap, FN Yap, K Perumal, R Rajandram
    BJU INTERNATIONAL 122, 12-12 , 2018
    2018
  • The evaluation of Leptin as an appropriate biomarker for the early detection of renal cell carcinoma (RCC): A systematic review and meta-analysis
    K Perumal, WK Huin, NY Yap, TA Ong, GC Gobe, R Rajandram
    BJU International 122, 13-13 , 2018
    2018