Abstract Cancer is a leading cause of death in Asia, and within the next 20 years, Asia will bear more than half of the world's cancer burden. In Singapore, cancer represents the largest recipient of funding for biomedical research and the leading therapeutic area for clinical trials. Clinical trials should be conducted in Asia for a number of important reasons. First, the phenotypic expression of certain cancers is different between Asia and the West. A commonly cited difference is in non-small cell lung cancer, where the high expression of a mutated epidermal growth factor receptor (EGFR) in nonsmoking Asians, especially women, confers on them a greater sensitivity to EGFR tyrosine kinase inhibitors, e.g. gefitinib and erlotinib. This has led to a change in the management of first line non-small cell lung cancer, with mutation positive patients benefitting from gefitinib more than paclitaxel and carboplatin as first line treatment (NEJM 2009; 361(10): 947-57). The metabolism of certain common cytotoxic drugs, such as doxorubicin, is affected by genotypes that are different in Chinese and Malay populations, compared to Indian and Caucasian populations, leading to differences in toxicities and thus possibly dosages (Pharmacogenetics and Genomics 2008, 18:621—629). Asia has well-trained doctors and scientists who can provide yet another site to accelerate drug development. Singapore was the site of the first-in-world trial of linifanib, a highly active oral inhibitor of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF). It has moved from phase I to phase III testing in 3 years and has shown promising activity in several common cancers (J Clin Oncol 2009; 27:4718-4726). Asia's economic growth and increasingly educated population has led to a demand for cancer care as well as the means to afford it. Asia is also one of the fastest growing markets for the pharmaceutical industry. For these reasons, universities and research institutes in Asia have formed centers of excellence to complement those in the West.