Clinicla Research & Fundings
- Cancer Breakthroughs
- What is Clinical Research?
- Why is Cancer research important?
Cancer Breakthroughs
Targeted cancer therapy
Carcinoma – Cancer with tumor made of epithelial (skin) cells.Immunotherapy (Checkpoint blockade therapy)
■ The immune response is
■ Antibody drugs target specific receptors
Adopted Cell Transfer - Immunotherapy using adopted T-cell therapy
● T-cells are lymphocytes (white blood cells).
● Basic process – T cells are extracted from patient's blood, genetically engineered to exhibit Chimeric Antigen Receptors (CAR) towards antigens found on tumor cells. With those CARs, the T-cells will be able to recognize and target those cancer cells. The engineered T-cells are then lab cultured and then reinserted into the body.
■ These T-cells can also be modified to be more resistant to tumor-derived immunosuppression that would prevent unmodified lymphocytes from attacking the tumor cells, as well as to be more vulnerable to immunosuppressant drugs that can kill the T-cells if they become out of control.
■ Research is still in early stages
■ One study administered the ACT treatment to 14 patients with two types of B cell lymphoma. Most of these patients had proven to have chemotherapy refractory (resistant or nonresponsive to chemotherapy) malignancies. Out of 14 patients, 5 had complete remissions (no more cancer) of up to 19 months and 6 had partial remissions (one up to 20 months).
● ACT can also be used to treat carcinomas and solid tumors.
● Research into this type of therapy is still at early stages, with existing research being small scale and the results still tentative. More research is needed to determine whether ACT can become another pillar of cancer treatment like surgery, radiotherapy, or chemotherapy.
https://ash.confex.com/ash/2013/webprogram/Paper62867.html
http://www.cancer.gov/cancertopics/research-updates/2013/CAR-T-Cells
Kershaw, M. H., Westwood, J. A., & Darcy, P. K. (2013). Gene-engineered T cells for cancer therapy. Nature Reviews Cancer, 13(8), 525-541.
What is Clinical Research?
● Clinical trials are research studies that involve people. These studies test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists' knowledge about cancer and to help in the development of improved cancer treatments. They also receive state-of-the-art care from cancer experts.
■ Treatment. These trials test the effectiveness of new treatments or new ways of using current treatments in people who have cancer. The treatments tested may include new drugs or new combinations of currently used drugs, new surgery or radiation therapytechniques, and vaccines or other treatments that stimulate a person's immune system to fight cancer. Combinations of different treatment types may also be tested in these trials.
■ Prevention. These trials test new interventions that may lower the risk of developing certain types of cancer. Most cancer prevention trials involve healthy people who have not had cancer; however, they often only include people who have a higher than average risk of developing a specific type of cancer. Some cancer prevention trials involve people who have had cancer in the past; these trials test interventions that may help prevent the return (recurrence) of the original cancer or reduce the chance of developing a new type of cancer
■ Screening. These trials test new ways of finding cancer early. When cancer is found early, it may be easier to treat and there may be a better chance of long-term survival. Cancer screening trials usually involve people who do not have any signs or symptoms of cancer. However, participation in these trials is often limited to people who have a higher than average risk of developing a certain type of cancer because they have a family history of that type of cancer or they have a history of exposure to cancer-causing substances (e.g., cigarette smoke).
■ Diagnostic. These trials study new tests or procedures that may help identify, or diagnose, cancer more accurately. Diagnostic trials usually involve people who have some signs or symptoms of cancer.
■ Quality of life or supportive care. These trials focus on the comfort and quality of life of cancer patients and cancer survivors. New ways to decrease the number or severity of side effects of cancer or its treatment are often studied in these trials. How a specific type of cancer or its treatment affects a person's everyday life may also be studied.
● Therapies that undergo clinical trials not only include new therapies or treatments but also new combinations of existing therapies or treatments.
● Phases of human clinical research
■ Phase 1: Researchers test a new drug in humans using a sequence of steadily escalating doses to determine how the drug behaves in the body as well as the highest safe dosing level (called the Maximum Tolerated Dose) that are well tolerated by the body. Participants are monitored (usually in a hospital or clinic) to identify any side effects.
◆ Because Phase I trials are meant to discover the adverse effects of a new drug, participants can be healthy or sick
■ Phase II: These trials test the effectiveness of interventions in people who have a specific type of cancer or related cancers and continue to look at the safety and side effects of the new intervention. Phase II trials test whether an intervention works, but rarely compare what is being tested to see if it is superior to existing standard treatments.
◆ Phase II participants do have the health problem being treated, and enrolling in a Phase II trial can be a way to receive untested, cutting edge drugs and therapies that would otherwise be unavailable.
■ Phase III (also called phase 3): These trials compare the effectiveness of a new intervention, or new use of an existing intervention, with the current standard of care (usual treatment) for a particular type of cancer. Phase III trials also examine how the side effects of the new intervention compare with those of the usual treatment. If the new intervention is more effective than the usual treatment and/or is easier to tolerate, it may become the new standard of care.
◆ Phase III trials are often much larger than Phase I and II trials, with study sizes in the hundreds to thousands of people.
◆ Good Phase III trials are randomized (participants are randomly allocated to a group receiving an experimental intervention and a control group), blinded or double-blinded, and have a control group (which in the case of cancer is the standard treatment plus a placebo, as opposed to the standard treatment plus the experimental therapy.
◆ Positive results from Phase III trials, as well as the preceding Phase I and II results, are used to gain approval for marketing from the national drug regulatory authority.
◆http://www.cancer.gov/cancertopics/factsheet/clinicaltrials/clinical-trials
■ Phase IV: These trials after the drug has been approved for marketing by the local governing body and is in use. They are designed to monitor the long term effects of the intervention as well as any long term adverse effects that might not manifest in Phase III trials..
1. What are some of the possible benefits of taking part in a clinical trial?
The benefits of participating in a clinical trial include the following:
● Trial participants have access to promising new interventions that are generally not available outside of a clinical trial.
● The intervention being studied may be more effective than standard therapy. If it is more effective, trial participants may be the first to benefit from it.
● Trial participants receive regular and careful medical attention from a research team that includes doctors, nurses, and other health professionals.
● The results of the trial may help other people who need cancer treatment in the future.
● Trial participants are helping scientists learn more about cancer (e.g., how it grows, how it acts, and what influences its growth and spread).
2. What are some of the potential harms associated with taking part in a clinical trial?
The potential harms of participating in a clinical trial include the following:
● The new intervention being studied may not be better than standard therapy, or it may have harmful side effects that doctors do not expect or that are worse than those associated with standard therapy.
● Trial participants may be required to make more visits to the doctor than they would if they were not in a clinical trial and/or may need to travel farther for those visits.
● Health insurance may not cover all patient care costs in a trial.
Possible benefits
● When an experimental treatment is being studied in comparison to a standard treatment, it is possible that the participant might not receive the new treatment being tested. However, the participant will receive the best standard cancer treatment available.
● If the new drug being studied in a clinical trial works effectively to treat or prevent cancer, the participants in the study will be the first to benefit.
● In learning about clinical research and joining a clinical trial, a person takes an active role in a decision that affects their life. This can be personally empowering.
● The person may benefit from the extra follow-up care provided to participants.
● The person has a chance to help others and to improve the treatment of cancer.
● The person has a chance to further the knowledge of early detection, screening and diagnosis, supportive care and prevention of cancer, which could lead to improved outcomes.
● Cancer screening trials may encourage participants to continue checkups on a regular basis, which can lead to overall improved health.
Possible risks
● New drugs or treatments under study are not always better than, or as good as, the standard ones.
● There may be unexpected side effects that may be worse than those caused by standard drugs or treatments. A person is watched carefully during the study in case they have a bad reaction to the new drug or treatment.
● Although a new drug or treatment may have benefits, it may not work for every participant (just as a standard treatment may not work for everyone).
● Participants that get standard treatment may not benefit as much as those receiving the new one (if it is found to be more effective at treating cancer).
● Being in a clinical trial may take extra time or be inconvenient. A person may be required to have more tests or take extra medicines.
You are not just a guinea pig
● Informed consent is a process in which researchers provide potential and enrolled participants with information about a clinical study. This information helps people decide whether they want to enroll, or continue to participate, in the study. The informed consent process is intended to protect participants and should provide enough information for a person to understand the risks of, potential benefits of, and alternatives to the study.
■ In addition to the informed consent document, the process may involve recruitment materials, verbal instructions, question-and-answer sessions, and activities to measure participant understanding. In general, a person must sign an informed consent document before entering a study to show that he or she was given information on risks, potential benefits, and alternatives and understands it. Signing the document and providing consent is not a contract.
■ Participants may withdraw from a study at any time, even if the study is not over.
● Questions to Ask
● Anyone interested in participating in a clinical study should know as much as possible about the study and feel comfortable asking the research team questions about the study, the related procedures, and any expenses. The following questions might be helpful during such a discussion. Answers to some of these questions are provided in the informed consent document. Many of these questions are specific to clinical trials, but some also apply to observational studies.
■ What is being studied?
■ Why do researchers believe the intervention being tested might be effective? Why might it not be effective? Has it been tested before?
■ What are the possible interventions that I might receive during the trial?
■ How will it be determined which interventions I receive (for example, by chance)?
■ Who will know which intervention I receive during the trial? Will I know? Will members of the research team know?
■ How do the possible risks, side effects, and benefits of this trial compare with those of my current treatment?
■ What will I have to do?
■ What tests and procedures are involved?
■ How often will I have to visit the hospital or clinic?
■ Will hospitalization be required?
■ How long will the study last?
■ Who will pay for my participation?
■ Will I be reimbursed for other expenses?
■ What type of long-term follow-up care is part of this trial?
■ If I benefit from the intervention, will I be allowed to continue receiving it after the trial ends?
■ Will results of the study be provided to me?
■ Who will oversee my medical care while I am in the trial?
■ What are my options if I am injured during the study?
Read more:
http://www.ugc.edu.hk/rgc/rgcnews13/west/03.htm
New drug, BCT-001 for treatment of liver cancer (still in Phase 2 trials)
1. Ma BB, King A, Lo YM, Yau YY, Zee B, Hui EP, Leung SF, Mo F, Kam MK, Ahuja A, Kwan WH, Chan AT. Relationship between pretreatment level of plasma Epstein-Barr virus DNA, tumour burden, and metabolic activity in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2006;66:714-20.
2. Baujat B, Audry H, Bourhis J, Chan ATC, Onat H, Chua DTT, Kwong DL, Al-sarraf M, Chi KH, Hareyama M, Leung SF, Thephamongkhol K, Pignon JP. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys 2006;64(1):47-56. Review.
3. Mak SS, Yuen ML, Li C, Chan YK, Mo KF, Lee KM, Chan SJ. "Exploratory analysis of the bacteriological status of post-irradiation wounds and its relationship to healing", Clin Oncol 18(7):519-24, 2006
4. Leung SF, Zee B, Ma BB, Hui P, Mo F, Lai M, Chan KC, Chan LY, Kwan WH, Lo YM, Chan AT. Plasma epstein-Barr viral deoxyribonucleic acid quantitation complements tumour-node-metastasis staging prognostication in nasopharyngeal carcinoma. J Clin Oncol 2006;24:5414-8.
5. Sung FL, Pang RT, Ma BB, Lee MM, Chow SM, Poon TC, Chan AT. Pharmacoproteomics study of cetuximab in nasopharyngeal carcinoma. J Proteome Res 2006;5:3260-7.
6. Mok TS, Lui PC, To KF, Holmes J, Lai PBS, Wu YL, Yim PC, Ho SM, Janne P. Epidermal Growth Factor Receptor (EGFR) Exon 20 Mutations in Asian Lung and Liver Cancer. Annals of Oncology 2006 Sep;17(Supp. 9):856.
7. Teo PML, Leung SF, Tung SY, Zee B, Sham JS, Lee AWM, Lau WH, Kwan WH, Leung TW, Chua D, Sze WM, Au SJ, Yu KH, O SK, Kwong D, Yau TK, Law SC, Sze WK, Au G, Chan ATC. Dose-response relationship of nasopharyngeal carcinoma above conventional tumouricidal level: A study by the Hong Kong nasopharyngeal carcinoma study group (HKNPCSG). Radiother Oncol 2006;79:27-33.
8. Yeo W, Johnson PJ. Diagnosis, prevention and management of hepatitis B virus reactivation during anti-cancer therapy. Hepatol 2006;43(2):209-21.
9. Yeo W, Mo FKF, Koh J, Chan ATC, Leung T, Hui P, Chan L, Tang A, Lee JJ, Mok TSK, Lai PBS, Johnson PJ, Zee B. Quality of life is predictive of survival in patients with unresectable hepatocellular carcinoma. Ann. Oncol 2006;17:1083-89. The paper has been covered in the 'Research Highlights' section of Nature Clinical Practice Oncology (www.nature.com/clinicalpractice). And has also been selected for publication in Annals of Oncology, Spanish excerpted edition, Volume 3 Issue 5.
10. Ma B, Goh BC, Tan EH, Lam KC, Soo R, Leong S, Wang LZ, Mo F, Chan ATC, Zee B, Mok T. "A multicenter phase II trial of 3-aminopyridine-2-carboxaldehyde thiosemicarbzaone (2-AP, Triapine) and gemcitabine in advanced non-small-cell lung cancer with pharmacokinetic evaluation using peripheral blood mononuclear cell", Cancer Chemother Pharmacol. 2007 Aug 23
11. Ma B, Hui P, King A, To KF, Mo F, Leung SF, Kam M, Lo YMD, Zee B, Mok T, Ahuja A and Chan ATC. "A phase II study of patients with metastatic or locoregionally recurrent nasopharyngeal carcinoma and evaluation of plasma Epstein-Barr virus DNA as a biomarker of efficacy", Cancer Chemother Pharmacol. 2007 Aug 7
12. Engelman JA, Zejnullahu K, Mitsudomi T, Song Y, Hyland C, Park JO, Lindeman N, Gale C, Zhao X, Christensen J, Kosaka T, Holmes AJ, Rogers AM, Cappuzzo F, Mok TS, Lee C, Johnson BE, Cantley LC, Janne PA. MET amplification leads to gefitinib resistance in lung cancer by activating ERBB3 signaling. Science 2007;316:1039-43.
13. Kam MMK, Leung SF, Zee B, Chau RMC, Suen JJS, Mo F, Lai M, Ho R, Cheung KY, Yu BKH, Chiu SKW, Choi PHK, Teo PML, Kwan WH, Chan ATC. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol 2007;25:4873-9.
14. Mok TS, Ho, Chan G, Ho WM, Wong H, Chan ATC, Yeo W, Yim APC, Chak K, Lam KC. Sequential chemotherapy with combination irinotecan and cisplatin followed by docetaxel for treatment-naïve patients with advanced non-small cell lung cancer. J Thorac Oncol 2007;2(9):834-44.
15. Mok TSK, Yeo W, Johnson PJ, Hui P, Ho WM, Lam KC, Xu M, Chak K, Chan A, Wong H, Koh J, Mo F, Zee B. A double-blind placebo-controlled randomized study of Chinese herbal medicine as complimentary therapy for reduction of chemotherapy-induced toxicity. Ann Oncol 2007;18:768-74.
16. Tsang WK, Leung SF, Chiu KW, Yeung WK, Ng EKW, Yeo W, Lam KC, Chiu P, Ma B, Kwan WH, Chan ATC. Adjuvant chemoradiation for gastric cancer: experience in the Chinese population. Clin Oncol 2007;19:333-40.
17. Yeo W, Boyer M, Chung HC, Ong SYK, Lim R, Zee B, Ma B, Lam KC, Mo FKF, Ng EKW, Ho R, Clarke S, Roh JK, Beale P, Rha SY, Jeung HC, Soo R, Goh BC, Chan ATC. Irofulven as first line therapy in recurrent or metastatic gastric cancer: a phase II multicenter study by the Cancer Therapeutics Research Group (CTRG). Cancer Chemoth Pharm 2007;59(3):295-300.
18. Yeo W, Mo FKF, Chan SL, Leung NWY, Hui P, Lam WY, Mok TSK, Lam KC, Ho WM, Koh J, Tang JW, Chan AT, Chan PKS. Hepatitis B viral load predicts survival of patients with hepatocellular carcinoma (HCC) undergoing systemic chemotherapy. Hepatol 2007;45:1382-9.
19. Yeo W, Mo FKF. Does Hepatitis B viral load determine the outcome of patients with hepatocellular carcinoma undergoing chemotherapy? Letter to editor: In reply. Hepatol 2007;46(5):666.
20. Zhang N, Goh BC, Khoo YM, Yeo W, Lee HS.. A Simple and Sensitive High Performance Liquid Chromatography Method for Quantification of PXD101, a Histone Deacetylase Inhibitor in Human Plasma. Ther Drug Monit 2007;29:231-5.
21. Ma BB, Goh BC, Tan EH, Lam KC, Soo R, Leong SS, Wang LZ, Mo F, Chan AT, Zee B. A multicenter phase II trial of 3-aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP, Triapine®) and gemcitabine in advanced non-small-cell lung cancer with pharmacokinetic evaluation using peripheral blood mononuclear cells. Invest New Drugs 2008 Apr;26(2):169-173.
22. Ma B, Hui EP, King A, To KF, Mo F, Leung SF, Kam M, Lo YM, Zee B, Mok T, Ahuja A, Chan AT. A Phase II Study of Patients with Metastatic or Locoregionally Recurrent Nasopharyngeal Carcinoma and Evaluation of Plasma Epstein-Barr Virus DNA as a Biomarker of Efficacy. Cancer Chemother Pharmacol. 2008 Jun;62(1):59-64.
23. Chan HLY, Tse CH, Mo F, Koh J, Wong VWS, Wong GLH, Chan SL, Yeo W, Sung JJY, Mok TSK. High viral load and hepatitis B virus subgenotype Ce are associated with increased risk of hepatocellular carcinoma. J Clin Oncol 2008;26(2):177-82.
24. Kim ES, Hirsh V, Mok T, Socinski MA, Gervais R, Wu YL, Li LY, Watkins CL, Sellers MV, Lowe ES, Sun Y, Liao ML, Osterlind K, Reck M, Armour AA, Shepherd FA, Lippman SM, Douillard JY. Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase III trial. Lancet. 2008 Nov 22;372(9652):1809-18.
25. King AD, Ahuja AT, Leung SF, Abrigo J, Wong JK, Poon WS, Woo KS, Chan HS, Tse GM. MR imaging of nonmalignant polyps and masses of the nasopharynx and sphenoid sinus after radiotherapy for nasopharyngeal carcinoma. Am J Neuroradiol. 2008;29:1209-14.
26. Mak SS, Yeo W, Lee YM, Mo KF, Tse KY, Ho FP, Kwan WH. "Predictors of lymphedema in patients with breast cancer undergoing axillary lymph node dissection in Hong Kong," Nurs Res. 2008 Nov-Dec; 57 (6):416-25
27. Wong N, Yeo W, Wong WL, Wong NLY, Chan KYY, Mo FKF, Koh J, Chan SL, Chan ATC, Lai PBS, Ching AKK, Tong JHM, Ng HK, Johnson PJ, To KF. "TOP2A overexpression in hepatocellular carcinoma correlated with early age onset, shorter patients survival and chemoresistance." International Journal of Cancer, Sep 2 2008, P644-652
28. Yu SCH, Hui P, Wong H, Mo FK, Ho SM, Wong, Yeun, Yeo W, Lai BS, Chan ATC, Mok TS. "Transarterial Ethanol Ablation of Hepatocellular Carinoma with Lipiodol-Ethanol Mixture: Phase II study." J Vasc Interv Radiol: 19:95-103, 2008 Jan
29. Zee BCY, Lee JW, Wong N, Yeo W, Lai PBS, Mok TSK, Chan AT. A Prognostic Model for The Combined Analysis of Gene Expression Profiling in Hepatocellular Carcinoma. Bioinformation. 2008 Jul. 2(9):395-400.
30. Abrigo JM, King AD, Leung SF, Vlantis AC, Wong JK, Tong MC, Tse GM, Ahuja AT. MRI of Radiation-induced Tumors of the Head and Neck in Post-radiation Nasopharyngeal Carcinoma. Eur Radiol. 2009 May;19(5):1197-205.
31. Ma BB, Hui EP, Wong SC, Tung SY, Yuen KK, King A, Chan SL, Leung SF, Kam MK, Yu BK, Zee B, Chan AT. Multicenter phase II study of gemcitabine and oxaliplatin in advanced nasopharyngeal carcinoma--correlation with excision repair cross-complementing-1 polymorphisms. Ann Oncol 2009;20(11):1854-9.
32. Chan SL, Mo F, Johnson PJ, Hui E, Ma B, Ho WM, Lam KC, Chan ATC, Mok T, Yeo W. A new utility of an old marker: serial alpha-fetoprotein measurement in predicting radiologic response and survival of patients with hepatocellular carcinoma undergoing systemic chemotherapy. J Clin Oncol 2009;27(3):446-52.
33. Douillard JY, Shepherd FA, Hirsh V, Mok T, Socinski MA, Gervais R, Liao ML, Bischoff H, Reck M, Sellers MV, Watkins CL, Speake G, Armour AA, Kim ES. Molecular predictors of outcome with gefitinib and docetaxel in previously treated non-small-cell lung cancer: data from the randomized phase III INTEREST trial. J Clin Oncol. 2010 Feb 10;28(5):744-52. Epub 2009 Dec 28.
34. Mak SS, Mo KF, Suen JJ, Chan SL, Ma WL, Yeo W. "Lymphedema and quality of life in Chinese women after treatment for breast cancer.", Eur J Oncol Nurs, 2009 Apr: 13(2): 110-5
35. Hui EP, Ma B, Leung SF, King AD, Mo F, Kam MKM, Yu BYH, Chiu SKW, Kwan WH, Ho R, Chan I, Ahuja AT, Zee B, Chan ATC. Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant chemotherapy using docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol 2009;27(2):242-9.
36. Mok TS, Wu YL, Thongpraser S. Yang CH, Chu DT, Saijo N, Sunpaweravong P, Han BH, Margono B, Ichinose Y, Nishiwaki Y. Ohe Y, Yang JJ, Chewaskulyong B, Jiang HY, Duffiekd EL, Watkins CL, Armour AA, Fukuoka M. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma . N Engl J Med 2009;361(10):947-57.
37. Mok TS, Wu YL, Yu CJ, Zhou C, Chen YM, Zhang L, Ignacio J, Liao M, Srimuninnimit V, Boyer MJ, Chua-Tan M, Sriuranpong V, Sudoyo AW, Jin K, Johnston M, Chui W, Lee JS. Randomized, placebo-controlled, phase II study of sequential erlotinib and chemotherapy as first-line treatment for advanced non-small-cell lung cancer. J Clin Oncol 2009;27(30):5080-7.
38. Yeo W, Chan TC, Leung NW, Lam WY, Mo FK, Chu MT, Chan HL, Hui EP, Lei KI, Mok TS, Chan PK. Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab. J Clin Oncol 2009;27(4):605-11.
39. YeoY, Mo FKF, Suen JJS, Ho WH, Lau W, Koh J, Weung WK, Kwan WH, Lee KKC, Mok TSK, Poon ANY, Lam KC, Hui EK, Zee B. "A randomized phase II study of aprepitant, ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting in Chinese breast cancer patients receiving moderately emtogenic chemotherapy", Breast Cancer Research and Treatment 2009 Feb;113:529-535.
40. Wee JT, Anderson BO, Corry J, D'Cruz A, Soo KC, Qian CN, Chua DT, Hicks RJ, Goh CH, Khoo JB, Ong SC, Forastiere AA, Chan AT; Asian Oncology Summit Management of the neck after chemoradiotherapy for head and neck cancers in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol. 2009 Nov;10(11):1086-92.
41. Wong N, Yeo W, Wong WL, Wong NL, Chan KY, Mo FK, Koh J, Chan SL, Chan AT, Lai PB, Ching AK, Tong JH, Ng HK, Johnson PJ, To KF. TOP2A overexpression in hepatocellular carcinoma correlates with early age onset, shorter patients survival and chemoresistance. Int J Cancer. 2009 Feb 1;124(3):644-52.
42. Yu SC, Hui JW, Hui EP, Mo F, Lee PS, Wong J, Lee KF, Lai PB, Yeo.W "Embolization efficacy and treatment effectiveness of transarterial therapy for unresectable hepatocellular carcinoma: a case-controlled comparison of transarterial ethanol ablation with lipiodol-ethanol mixture versus transcatheter arterial chemoembolization." J Vasc Interv Radiol, 2009 Mar: 20(3):352-9
43. Ma BB, Hui EP, Mok TS. Population-based differences in treatment outcome following anticancer drug therapies. Lancet Oncol 2010;11(1):75-84.
44. Ma BB, Loong H. Personalized cancer therapy coming of age – clinical highlights in 2009 and future directions. Personalized Medicine 2010;7: 121-124.
45. King AD, Griffith JF, Abrigo JM, Leung SF, Yau FK, Tse GM, Ahuja AT. Osteoradionecrosis of the Upper Cervical Spine: MR Imaging Following Radiotherapy for Nasopharyngeal Carcinoma. Eur J Radiol. 2010 Mar;73(3):629-35.
46. King AD, Mo FK, Yu KH, Yeung DK, Zhou H, Bhatia KS, Tse GM, Vlantis AC, Wong JK, Ahuja AT. Squamous cell carcinoma of the head and neck: diffusion-weighted MR imaging for prediction and monitoring of treatment response. Eur Radiol. 2010 Sep;20(9):2213-20.
47. King AD, Yeung DK, Yu KH, Mo FK, Bhatia KS, Tse GM, Vlantis AC, Wong JK, Hu CW, Ahuja AT. Pretreatment and Early Intratreatment Prediction of Clinicopathologic Response of Head and Neck Cancer to Chemoradiotherapy using 1H-MRS. J Magn Reson Imaging. 2010 Jul;32(1):199-203.
48. King AD, Yeung DK, Yu KH, Mo FK, Hu CW, Bhatia KS, Tse GM, Vlantis AC, Wong JK, Ahuja AT. Monitoring of Treatment Response After Chemoradiotherapy for Head and Neck Cancer Using in Vivo 1H MT Spectroscopy. Eur Radiol. 2010 Jan;20(1):165-72.
49. Lin CC, Hsu HH, Sun CT, Shih JY, Lin ZZ, Yu CJ, Chen GG, Hsin MK, Lam KC, Leung L, Yang CH, Mok T. Chemotherapy response in East Asian non-small cell lung cancer patients harboring wild-type or activating mutation of epidermal growth factor receptors. Journal of Thoracic Oncology 2010;5:1424-1429
50. Ma AT, Ma BB, Lei KI, Mo FK, Chan AT. Clinical predictors of response to cetuximab-chemotherapy in metastatic colorectal cancer. Hong Kong Med J. 2010 Jun;16(3):207-12.
51. Hui EP, Lui VW, Wong CS, Ma BB, Lau CP, Cheung CS, Ho K, Cheng SH, Ng MH, Chan AT. Preclinical evaluation of sunitinib as single agent or in combination with chemotherapy in nasopharyngeal carcinoma. Invest New Drugs 2010 May 15. [Epub ahead of print]
52. Turke AB, Zejnullahu K, Wu YL, Song Y, Dias-Santagata D, Lifshits E, Toschi L, Rogers A, Mok T, Sequist L, Lindeman NI, Murphy C, Akhavanfard S, Yeap BY, Xiao Y, Capelletti M, Iafrate AJ, Lee C, Christensen JG, Engelman JA, Jänne PA. Preexistence and clonal selection of MET amplification in EGFR mutant NSCLC. Cancer Cell. 2010 Jan 19;17(1):77-88.
53. Yeo Y, Mo FKF, Hui P, Chan SL. 'Need of Stratifying Patients According to Severity of Underlying Liver Disease for Hepatocellular Carcinoma Patients Undergoing Systemic Therapy Trials', Contemporary Clinical Trail 2010; 31:135
54. Wong VW, Chan SL, Mo F, Chan TC, Loong HH, Wong GL, Lui YY, Chan AT, Sung JJ, Yeo W, Chan HL, Mok TS Clinical scoring system to predict hepatocellular carcinoma in chronic hepatitis B carriers. J Clin Oncol 2010;28(10):1660-5.
55. Chan SL, Mo F, Johnson PJ, Liem GS, Chan TC, Poon MC, Ma BB, Leung TW, Lai PB, Chan AT, Mok TS, Yeo W. Prospective validation of the Chinese University Prognostic Index and comparison with other staging systems for hepatocellular carcinoma in an Asian population. Journal of Gastroenterology and Hepatology 2011;26:340-347.
56. Fukuoka M, Wu YL, Thongprasert S, Sunpaweravong P, Leong SS, Sriuranpong V, Chao TY, Nakagawa K, Chu DT, Saijo N, Duffield EL, Rukazenkov Y, Speake G, Jiang H, Armour AA, To KF, Yang JC, Mok TS. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non-small-cell lung cancer in Asia (IPASS). J Clin Oncol. 2011 Jul 20;29(21):2866-74.
57. Hui EP, Leung LK, Poon TC, Mo F, Chan VT, Ma AT, Poon A, Hui EK, Mak SS, Lai M, Lei KI, Ma BB, Mok TS, Yeo W, Zee BC, Chan AT. Prediction of outcome in cancer patients with febrile neutropenia: a prospective validation of the Multinational Association for Supportive Care in Cancer risk index in a Chinese population and comparison with the Talcott model and artificial neural network. Support Care Cancer. 2011 Oct;19(10):1625-35. [Epub 2010 Sep 4.]
58. Hui EP, Lui VW, Wong CS, Ma BB, Lau CP, Cheung CS, Ho K, Cheng SH, Ng MH, Chan AT. Preclinical evaluation of sunitinib as single agent or in combination with chemotherapy in nasopharyngeal carcinoma Invest New Drugs. 2011 Dec;29(6):1123-31. [Epub 2010 May 15]
59. Hui EP, Ma BB, King AD, Mo F, Chan SL, Kam MK, Loong HH, Ahuja AT, Zee BC, Chan AT. Hemorrhagic complications in phase II study of sunitinib in patients of nasopharyngeal carcinoma who has previously received high-dose radiation. Annals of Oncology 2011;22:1280-1287.
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Why is Cancer research important?
Malignant neoplasms (cancers) are the leading cause of death in Hong Kong. In 2012, 13,336 Hong Kong residents died due to cancer, at a death rate of 186.4 deaths out of every 100,000 Hong Kong residents. Across the globe, cancer killed 8.2 million people that year.
The burden of cancer deaths in Hong Kong has been increasing over time, having grown 14% in the 10 years since 2002. Cancer survivors, as well as their family members, friends, and caregivers, may face physical, emotional, social, and spiritual challenges as a result of their cancer diagnosis and treatment. Cancer also incurs tremendous financial and economic costs, both to patients (the cost of cancer therapies, doctor's visits, care giving, and lost income) as well as to society (in lost productivity).
Cancer remains a tremendous burden in Hong Kong and around the world, and the best way to reduce this burden is to dedicate more resources to further cancer research. Not only can cancer research add to the body of knowledge about how the cancers work at all stages of the disease, through the principles of translational medicine this knowledge can be applied to develop and test novel, more effective ways of preventing, detecting, and treating cancer.
Why is clinical research important?
Clinical research is the only way to evaluate the performance of a new drug, treatment, or combination of treatments in human beings before it is released into the general population. Clinical research trials are used to:
◆ Evaluate the safety of the new treatment and the side-effects that it can cause.
◆ Determine the treatment's effectiveness achieving some kind of positive health outcome.
For many cancer drugs intended to treat late-stage, metastasized cancer, this outcome can be a regression, or decrease in the size of the tumor, a complete remission where the tumor disappears entirely and can no longer be detected, or a halt in the growth of the tumor. These responses can be temporary.
◆ Determine whether or not these new treatments are as good as or better than existing treatments. Phase III (large scale testing) trials compare the new treatment, alone or alongside an existing standard treatment, with the standard treatment and a placebo.
Clinical research is necessary to obtain medical knowledge about the effects, beneficial and harmful, of a new drug or treatment on the human body. It is important to learn about the efficacy and harms of new treatments before they are released to the public, where much larger numbers of people could be exposed to a potentially harmful treatment.
What is translational medicine?
Also known as "bench to bedside" medicine, translational medicine is a discipline that focuses on turning basic research, which examines the mechanisms of disease in cell and tissue cultures or animal models, into interventions and therapies that can be used to detect and treat cancer.