3rd Hong Kong International Oncology Symposium

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1 HKSCO 3rd Hong Kong International Oncology Symposium Date: 28-30th October 2016 Venue: Lecture Theatre, 12/F, Block R, Queen Elizabeth Hospital ios.org.hk Co-organizers: Hong Kong Lung Cancer Study Group Hong Kong Society of Clinical Oncology Supporting co-organizers: City University of Hong Kong Research Committee, Queen Elizabeth Hospital / Kowloon Central Cluster Hong Kong College of Radiologists Hong Kong Thyroid Society Hong Kong Neuro-Oncology Society Hong Kong Proton Therapy Study Group

2 CONTENTS INTRODUCTION 4 OVERSEAS FACULTIES 5 LOCAL FACULTIES 7 PROGRAM 10 BIOGRAPHIES OF SPEAKERS AND ABSTRACTS OF LECTURES 1. CD19 CAR-T cell therapies for B cell malignancies 17 Cameron Turtle, Seattle Cancer Care Alliance, USA 2. Immunotherapy of B-cell malignancies 18 Yok-Lam Kwong, University of Hong Kong 3. Functional genomic approaches in precision oncology: a case study in identifying new therapeutic targets for glioblastoma 19 Patrick Paddison, Fred Hutchison Cancer Research Center, USA 4. Radiation and cancer immunotherapy 20 Ramesh Rengan, Department of Radiation Oncology, University of Washington, USA 5. Optimising the management of metastatic renal cancer: translating the evidence into practice 21 John Wagstaff, South West Wales Cancer Institute & Swansea College of Medicine, UK 6. Nano-technologies in cancer diagnostics and therapy 22 Michael Yang, City University of Hong Kong 7. Hereditary breast cancer in Hong Kong 23 Ava Kwong, University of Hong Kong 8. Liquid biopsies 24 Allen Chan, Chinese University of Hong Kong 9. Clinical experience of plasma EGFR testing in lung cancer 25 Y C Li, Queen Elizabeth Hospital 10. NPC in Hong Kong over previous 60 years 26 Anne Lee, Clinical Professor and Head, Clinical Oncology, University of Hong Kong 11. Translational research in Nasopharygeal carcinoma over 60 years 27 Timothy Yip, Queen Elizabeth Hospital 12. Clinical Application of NGS in Precision Cancer Medicine 28 Shu-Jen Chen, ACT genomics 13. Application of NGS to oncology in Hong Kong 29 Chris Wong, Hong Kong Molecular Pathology Diagnostic Centre 14. NGS Testing for gene mutations and translocations for targeted therapy 30 Zongli Zheng, City University of Hong Kong 15. Molecular subtypes of colorectal cancer 31 Xin Wang, City University of Hong Kong - 1 -

3 16. Hong Kong Neuro-Oncology Society (HKNOS) ASM lecture: WHO 2016 brain tumours classification 32 Professor Ho-Keung Ng, The Chinese University of Hong Kong 17. Personalized treatment in metastatic CRC 33 Peter Gibbs, University of Melbourne, Australia 18. Colorectal Cancer in Chinese 34 Brigette Ma, Chinese University of Hong Kong 19. QMH Experience 35 Ka-On Lam, University of Hong Kong 20. QEH Experience 36 Irene Kwok, Queen Elizabeth Hospital, Hong Kong 21. Changing epidemiology of cancers in Hong Kong from East to West 37 Roger Ngan, Director, Hong Kong Cancer Registry & Chief of Service in Clinical Oncology, Queen Elizabeth Hospital 22. Epidemiology of lung cancer in Hong Kong 38 Shelly Lap-ah TSE, Chinese University of Hong Kong 23. The Golden Age of Radiotherapy 39 Simon Lo, Department of Radiation Oncology, University of Washington, USA 24. Proton therapy the better radiotherapy 40 Tony Wong, Seattle Cancer Care Alliance, USA 25. The role of functional imaging in personalized medicine 41 Dr Lilie Lin, University of Pennsylvania 26. Radiotherapy for early lung cancer 42 Jing Zeng, Department of Radiation Oncology, University of Washington, USA 27. Chemoradiotherapy for locally advanced nonsmall cell lung cancer 43 Joseph Siu-Kie Au, Queen Elizabeth Hospital, Hong Kong 28. Management of mesothelioma 44 Patricia Tai, Allan Blair Cancer Center, Canada 29. SBRT for oligo-metastases 45 Mitchell Liu, BC Cancer Agency, Canada 30. Overview of management of liver cancers 46 Ronnie Poon, Hong Kong Integrated Oncology Centre 31. Proton radiotherapy for GI/liver cancers 47 Gary Yang, Loma Linda University Medical Center, USA 32. The New Role of Anti-Angiogenesis in Advanced Gastric Cancer 48 Winnie Yeo, Chinese University of Hong Kong 33. Management of neuro-endocrine tumours 49 Victor Lee, University of Hong Kong 34. SBRT for liver cancers 50 Roy Ma, BC Cancer Agency, Canada - 2 -

4 35. Experience of SBRT for hepatocellular carcinom 51 Hoi-Ching Cheng, Queen Elizabeth Hospital, Hong Kong 36. Experience of SIRT for hepatocellular carcinoma 52 Anna Yin-Ping Tai, Queen Elizabeth Hospital, Hong Kong 37. Towards Personalization of Head and Neck Cancer 53 Nancy Lee, Memorial Sloan Kettering Cancer Center, USA 38. Proton therapy for head and neck cancers 54 Annie Waifong Chan, Massachusetts General Hospital, USA 39. Targeted Treatment in Well Differentiated Carcinoma of Thyroid 55 SM Chow, Clinical Oncology Specialist, Hong Kong 40. Radiotherapy for thyroid cancers 56 Jonn Wu, BC Cancer Agency, Canada 41. Experience of IMRT of neck for thyroid cancer 57 CK Kwan, United Christian Hospital, Hong Kong 42. Overview of Radiotherapy for head and neck cancers 58 Upendra Parvathaneni, Department of Radiation Oncology, University of Washington, USA 43. Experience of IMRT for NPC 59 K H Au, Queen Elizabeth Hospital, Hong Kong 44. Lung Cancer: New Targeted Therapies in Lung Cancer 60 Benjamin Solomon, Peter MacCallum Cancer Centre) 45. Sharing of experience of new targeted therapies of lung cancer 61 PWH experience: Kwok-Chi Lam, Prince of Wales Hospital 46. Sharing of experience of new targeted therapies of lung cancer 62 PYNEH experience: Oscar Chan, Pamela Youde Nethersole Eastern Hospital, Hong Kong 47. Sharing of experience of new targeted therapies of lung cancer 63 QEH experience: Y C Li, Queen Elizabeth Hospital 48. Sharing of experience of new targeted therapies of lung cancer 64 QMH experience: James Ho, Queen Mary Hospital 49. Clinical Oncology residency training in Hong Kong 65 Frank Chi-Sing Wong, Tuen Mun Hospital, Hong Kong 50. Radiation Oncology residency training in US 66 Gabrielle Kane, Department of Radiation Oncology, University of Washington, USA 51. Medical Physics residency training in Hong Kong 67 Francis Lee, Queen Elizabeth Hospital, Hong Kong 52. Radiotherapists training in Hong Kong 68 Eric Lam, Queen Elizabeth Hospital, Hong Kong - 3 -

5 INTRODUCTION We have come to a golden era of rapid progress in the management of cancer. The striking achievements include biomarker testing using next generation sequencing technologies, liquid biopsies, new targeted agents, immunotherapies and proton therapy. These will form the main themes of the 3rd HKiOS this year. It is not sufficient just to prove that such new treatments can improve the survival and quality of life of our patients. It is equally important to ensure that our patients can have access to such treatments as early as possible this will involve breaking down of barriers mainly due to the lack of knowledge amongst professionals, health administrators and the community as a whole. Due to the explosion in knowledge, the first most important task of HKiOS is to educate our fellow colleagues in all related disciplines and to ensure that they are kept abreast of all such new developments. Secondly, we should promote their networking with the more experienced experts in the field and establishment of collaborations between different cancer centres around the world so that they can have first-hand knowledge and opportunities for practice. Thirdly, we should advocate such new treatments and facilitate the health administrators and the community to set priorities in the allocation of resources. The theme of the first and second HKiOS was on functional imaging and proton therapy respectively. We have been very successful in arousing the attention and interest of our colleagues through their keen participation. The programme of this year has been greatly expanded to accommodate all the new exciting themes. I am looking forward to a fruitful symposium again. Dr. Joseph Siu-Kie AU Chairman of the Organizing committee, HKiOS - 4 -

6 OVERSEAS FACULTIES Annie Waifong Chan Massachusetts General Hospital, Boston, USA Mitchell Liu British Columbia Cancer Agency, Vancouver, Canada Shu-Jen Chen ACT Genomics, Taipei, Taiwan Simon Lo University of Washington, Seattle, USA Peter Gibbs University of Melbourne, Melbourne, Australia Roy Ma British Columbia Cancer Agency, Vancouver, Canada Gabrielle Kane University of Washington, Seattle, USA Patrick Paddison Fred Hutchinson Cancer Research Center, Seattle, USA Nancy Lee Memorial Sloan Kettering Cancer Center, New York, USA Upendra Parvathaneni University of Washington, Seattle, USA Lilie Lin University of Pennsylvania, USA Ramesh Rengan University of Washington, Seattle, USA) - 5 -

7 OVERSEAS FACULTIES Benjamin Solomon Peter MacCallum Cancer Center, Melbourne, Australia Tony Wong Seattle Cancer Care Alliance, Seattle, USA Patricia Tai Allan Blair Cancer Center, Regina, Canada John Wu British Columbia Cancer Agency, Vancouver, Canada Cameron Turtle Fred Hutchinson Cancer Research Center, Seattle, USA Gary Yang Loma Linda University, Loma Linda, USA John Wagstaff Swansea University, Swansea, UK Jing Zeng University of Washington, Seattle, USA) - 6 -

8 LOCAL FACULTIES Joseph Siu-Kie Au Queen Elizabeth Hospital James Ho University of Hong Kong Kwok-Hung Au Queen Elizabeth Hospital Chung-Kong Kwan Queen Elizabeth Hospital Allen Chan Chinese University of Hong Kong Irene Kwok Queen Elizabeth Hospital Oscar Chan Pamela Youde Nethersole Eastern Hospital Ava Kwong University of Hong Kong Hoi-Ching Cheng Queen Elizabeth Hospital Yok-Lam Kwong University of Hong Kong Sin-Ming Chow Hong Kong Thyroid Society Eric Lam Queen Elizabeth Hospital - 7 -

9 LOCAL FACULTIES Ka-On Lam University of Hong Kong Brigette Ma Chinese University of Hong Kong Kwok-Chi Lam Prince of Wales Hospital Ho-Keung Ng Chinese University of Hong Kong Anne Lee University of Hong Kong Roger Ngan Queen Elizabeth Hospital Francis Lee Queen Elizabeth Hospital Ronnie Poon Hong Kong Integrated Oncology Centre Victor Lee University of Hong Kong Anna Yin-Ping Tai Queen Elizabeth Hospital Jacky Li Queen Elizabeth Hospital Shelly Lap-Ah Tse Chinese University of Hong Kong - 8 -

10 LOCAL FACULTIES Xin Wang City University of Hong Kong Winnie Yeo Chinese University of Hong Kong Chris Wong Hong Kong Molecular Pathology Diagnostic Centre Timothy Yip Queen Elizabeth Hospital Frank Chi-Sing Wong Tuen Mun Hospital Zongli Zheng City University of Hong Kong Michael Yang City University of Hong Kong - 9 -

11 PROGRAM Date: 28 Oct 2016 (Friday) Venue: Lecture Theatre, 12/F, Block R, QEH 8:50-9:00 am Day 1 Opening Joseph Siu-Kie Au, Plenary Lectures: Breakthroughs of the decade Chairman of organizing committee, HKIOS Chairpersons: Chi-Kong Li (Professor, Department of Paediatrics, Chinese University of Hong Kong) June Lau (Haematology-Oncology Specialist, Queen Elizabeth Hospital) 9:00-9:35 am CD19 CAR-T cell therapies for B cell malignancies 9:35-10:05 am Immunotherapy of B-cell malignancies Cameron Turtle, Seattle Cancer Care Alliance, USA Yok-Lam Kwong, University of Hong Kong 10:05-10:40 am Functional genomic approaches in precision oncology: a case study in identifying new therapeutic targets for glioblastoma 10:40-10:55 am Break Patrick Paddison, Fred Hutchison Cancer Research Center, USA Chairpersons: Joseph Siu-Kie Au (Queen Elizabeth Hospital) Timothy Yip (Queen Elizabeth Hospital) 10:55-11:30 am Radiation and cancer immunotherapy 11:30-12:00 pm Optimising the management of metastatic renal cancer: translating the evidence into practice 12:00-12:30 pm Nano-technologies in cancer diagnostics and therapy 12:30-12:40 pm Panel discussion 12:40-2:00 pm Lunch Ramesh Rengan, Department of Radiation Oncology, University of Washington, USA John Wagstaff, South West Wales Cancer Institute & Swansea College of Medicine, UK Michael Yang, City University of Hong Kong

12 Cancer genetics and diagnostics (1) Chairpersons: Ivan Lo (Consultant Clinical Geneticist, Clinical Genetic Services, Department of Health, Hong Kong) William Cho (Queen Elizabeth Hospital, Hong Kong) 2:00-2:30 pm Hereditary breast cancer in Hong Kong Ava Kwong, University of Hong Kong 2:30-3:00 pm Liquid biopsies Allen Chan, Chinese University of Hong Kong 3:00-3:15 pm Clinical experience of plasma EGFR testing in lung cancer 3:15-3:30 pm Discussion Nasopharyngeal carcinoma Y C Li, Queen Elizabeth Hospital Chairpersons: Wai-Tong Ng (Pamela Youde Nethersole Eastern Hospital) 3:30-3:45 am NPC in Hong Kong over previous 60 years 3:45-4:00 pm Translational research in Nasopharygeal carcinoma over 60 years Anne Lee, Clinical Professor and Head, Clinical Oncology, University of Hong Kong Timothy Yip, Queen Elizabeth Hospital 4:00-4:10 pm Discussion 4:10-4:20 pm Break Cancer genetics and diagnostics (2) Chairpersons: Michael Yang (City University of Hong Kong) Wah Cheuk (Queen Elizabeth Hospital) 4:20-4:50 pm Clinical Application of NGS in Precision Cancer Medicine 4:50-5:20 pm Application of NGS to oncology in Hong Kong 5:20-5:35 pm NGS Testing for gene mutations and translocations for targeted therapy 5:35-5:50 pm Molecular subtypes of colorectal cancer Shu-Jen Chen, ACT genomics Chris Wong, Hong Kong Molecular Pathology Diagnostic Centre Zongli Zheng, City University of Hong Kong Xin Wang, City University of Hong Kong 4:00-4:10 pm Discussion

13 Chairpersons: Stephen Yau (Queen Elizabeth Hospital) 6:00-6:30 pm Hong Kong Neuro-Oncology Society (HKNOS) ASM lecture: WHO 2016 brain tumours classification Professor Ho-Keung Ng, The Chinese University of Hong Kong Evening symposium Venue: Sheraton Hotel, TST, Hong Kong Chairpersons: Yiu-Tung Fu (Queen Elizabeth Hospital) 7:00-7:40 pm Personalized treatment in metastatic CRC Peter Gibbs, University of Melbourne, Australia 7:40-7:55 pm Colorectal Cancer in Chinese Brigette Ma, Chinese University of Hong Kong 7:55-8:05 pm QMH Experience Ka-On Lam, University of Hong Kong 8:05-8:15 pm QEH Experience Irene Kwok, Queen Elizabeth Hospital, Hong Kong 8:15-8:30 pm Panel discussion Dinner (8:25-10:00 pm)

14 Date: 29 Oct 2016 (Saturday) Venue: Lecture Theatre, 12/F, Block R, QEH 8:20-8:30 am Day 2 Opening Stephen Law, Plenary Lectures: International perspectives President, Hong Kong College of Radiologists Chairpersons: William Foo (Hong Kong Baptist Hospital) Chun-Chung Yau (Hong Kong Sanatorium) 8:30-8:50 am Changing epidemiology of cancers in Hong Kong from East to West Roger Ngan, Director, Hong Kong Cancer Registry & Chief of Service in Clinical Oncology, Queen Elizabeth Hospital 8:50-9:10 am Epidemiology of lung cancer in Hong Kong Shelly Lap-ah TSE, Chinese University of Hong Kong 9:10-9:30 am The Golden Age of Radiotherapy Simon Lo, Department of Radiation Oncology, University of Washington, USA 9:30-9:50 am Proton therapy the better radiotherapy Tony Wong, Seattle Cancer Care Alliance, USA 9:50-10:10 am The role of functional imaging in personalized medicine Dr Lilie Lin, University of Pennsylvania 10:10-10:30 am Panel discussion: The next steps in improving cancer care Coffee Break (10:30-11:00 am) Thoracic Malignancies Chairpersons: Macy Tong (Prince of Wales Hospital) Dora Kwong (University of Hong Kong) 11:00-11:20 pm Radiotherapy for early lung cancer Jing Zeng, Department of Radiation Oncology, University of Washington, USA 11:20-11:40 pm Chemoradiotherapy for locally advanced nonsmall cell lung cancer Joseph Siu-Kie Au, Queen Elizabeth Hospital, Hong Kong 11:40-12:00 pm Management of mesothelioma Patricia Tai, Allan Blair Cancer Center, Canada 12:00-12:20 pm SBRT for oligo-metastases Mitchell Liu, BC Cancer Agency, Canada 12:20-12:30 pm Panel discussion

15 Lunch (12:30-1:30 pm) Liver/GI Cancer Chairpersons: Victor Hsue (University of Hong Kong) Foon-Yiu Cheung (Hong Kong Integrated Oncology Centre) 1:30-1:50 pm Overview of management of liver cancers Ronnie Poon, Hong Kong Integrated Oncology Centre 1:50-2:20 pm Proton radiotherapy for GI/liver cancers Gary Yang, Loma Linda University Medical Center, USA 2:20-2:35 pm The New Role of Anti-Angiogenesis Winnie Yeo, in Advanced Gastric Cancer Chinese University of Hong Kong 2:35-2:50 pm Management of neuro-endocrine tumours Victor Lee, University of Hong Kong 2:50-3:10 pm SBRT for liver cancers Roy Ma, BC Cancer Agency, Canada 3:10-3:20 pm Experience of SBRT and SIRT for hepatocellular carcinoma Hoi-Ching Cheng & Anna Yin-Ping Tai, Queen Elizabeth Hospital, Hong Kong 3:20-3:30 pm Panel discussion Coffee Break (3:30-4:00 pm) H&N Cancers Chairpersons: Peter Teo (Central Comprehensive Cancer Centre, Hong Kong) Michael Kam (Prince of Wales Hospital, Hong Kong) 4:00-4:30 pm Towards Personalization of Head and Neck Cancer Nancy Lee, Memorial Sloan Kettering Cancer Center, USA 4:30-5:00 pm Proton therapy for head and neck Annie Waifong Chan, cancers Massachusetts General Hospital, USA 5:00-5:20 pm Targeted Treatment in Well SM Chow, Differentiated Carcinoma of Thyroid Clinical Oncology Specialist, Hong Kong 5:20-5:40 pm Radiotherapy for thyroid cancers Jonn Wu, BC Cancer Agency, Canada 5:40-5:50 pm Experience of IMRT of neck for thyroid cancer CK Kwan, United Christian Hospital, Hong Kong 5:50-6:10 pm Overview of Radiotherapy for head and neck cancers Upendra Parvathaneni, Department of Radiation Oncology, University of Washington, USA 6:10-6:20 pm Experience of IMRT for NPC K H Au, Queen Elizabeth Hospital, Hong Kong 6:20-6:30 pm Panel discussion

16 Evening symposium Venue: Sheraton Hotel, TST, Hong Kong Chairpersons: Joseph Siu-Kie Au (Queen Elizabeth Hospital, Hong Kong) 7:00-7:40 pm Lung Cancer: New Targeted Therapies in Lung Cancer (Benjamin Solomon, Peter MacCallum Cancer Centre) 7:40-8:25 pm Sharing of experience of new targeted therapies of lung cancer A. PWH experience: Kwok-Chi Lam, Prince of Wales Hospital (10 mins) B. PYNEH experience: Oscar Chan, Pamela Youde Nethersole Eastern Hospital, Hong Kong (15 mins) C. QEH experience: Y C Li, Queen Elizabeth Hospital (10 mins) D. QMH experience: James Ho, Queen Mary Hospital (10mins) 8:25-8:30 pm Panel Discussion Gala Dinner (8:30-10:00 pm)

17 Date: 30 Oct 2016 (Sunday) Venue: Lecture Theatre, 12/F, Block R, QEH Professional training Chairpersons: Kam-Hung Wong (Queen Elizabeth Hospital, Hong Kong) 10:00-10:20 am Clinical Oncology residency training in Hong Kong 10:20-10:40 am Radiation Oncology residency training in US 10:40-11:00 am Medical Physics residency training in Hong Kong 11:00-11:20 am Radiotherapists training in Hong Kong 11:20-11:30 am Panel discussion Lunch (12:00-2:00 pm) Faculty Meetings (2:00-7:00 pm) Networking and Dinner Frank Chi-Sing Wong, Tuen Mun Hospital, Hong Kong Gabrielle Kane, Department of Radiation Oncology, University of Washington, USA Francis Lee, Queen Elizabeth Hospital, Hong Kong Eric Lam, Queen Elizabeth Hospital, Hong Kong Platinum sponsors: AstraZeneca Hong Kong Limited Boehringer Ingelheim Hong Kong Ltd. Bristol-Myers Squibb Pharma (HK) Ltd. Eli Lilly Asia Inc Novartis Pharmaceuticals (HK) Ltd Pfizer Corporation Hong Kong Limited Roche Hong Kong Limited Co-organizers: Hong Kong Lung Cancer Study Group Hong Kong Society of Clinical Oncology Supporting co-organizers: City University of Hong Kong Research Committee, Queen Elizabeth Hospital / Kowloon Central Cluster Hong Kong College of Radiologists Hong Kong Thyroid Society Hong Kong Neuro-Oncology Society Hong Kong Proton Therapy Study Group

18 BIOGRAPHIES OF SPEAKERS AND ABSTRACTS OF LECTURES 1. CD19 CAR-T cell therapies for B cell malignancies Cameron Turtle, Seattle Cancer Care Alliance, USA Dr. Turtle trained as a physician in Sydney, Australia, completing dual Fellowships of the Royal Australasian College of Physicians and the Royal College of Pathologists of Australasia, and subsequently a PhD on the use of human blood dendritic cells for cancer immunotherapy at the University of Queensland (Brisbane, Australia). He then relocated to the Fred Hutchinson Cancer Research Center (FHCRC) in Seattle, USA, where he now serves as an attending physician on the Hematopoietic Stem Cell Transplant (HCT) Service and the Immunotherapy Service at FHCRC, Seattle Cancer Care Alliance (SCCA), and the University of Washington Medical Center. His research laboratory at FHCRC is focused on understanding the characteristics of distinct subsets of human CD8+ T cells, their role in immune reconstitution after allogeneic HCT, and their utility for immunotherapy of hematologic malignancies. Lymphodepletion chemotherapy followed by infusion of T cells that are genetically modified to express a chimeric antigen receptor (CAR) targeted to CD19 is a promising therapy for patients with relapsed and/or refractory B cell malignancies. Identification of factors that influence outcomes after CAR-T cell immunotherapy has been hindered in part due to the functional heterogeneity of infused CAR-T cell products. We are conducting the first clinical trial in which CD19 CAR-T cells are manufactured from distinct subsets of T cells and formulated in a defined composition for infusion to patients with acute lymphoblastic leukemia, non-hodgkin lymphoma or chronic lymphocytic leukemia. Clinical responses, toxicities and factors governing outcomes will be presented

19 2. Immunotherapy of B-cell malignancies Yok-Lam Kwong, University of Hong Kong Professor Kwong is chief of the Division of Haematology, Medical Oncology and Haematopoietic Stem Cell Transplantation at the Department of Medicine, University of Hong Kong. He is specialized in haematology and haematopathology. His clinical work focuses on the management of haematological malignancies. His team has special interests in the treatment of leukaemias and T-cell and natural killer cell malignancies. His research centers on the molecular pathogenetic pathways and novel treatment modalities in haematological neoplasms. Together with the clinical pharmacology team in his department, Professor Kwong has pioneered the development and use of oral arsenic trioxide in the treatment of acute promyelocytic leukaemia and other blood cancers. They hold four patents on the use of oral arsenic trioxide in the United States of America, European Union and Japan. His research team is also actively involved in defining the molecular defects and optimal treatment protocols for T-cell and natural killer cell lymphomas, which are neoplasms prevalent in Asian populations. Lymphomas are increasingly important malignancies, with their incidences increasing worldwide. According to the cellular lineage of origin, they can be divided into three broad groups: B-cell lymphomas, T-cell lymphomas, and natural killer (NK)-cell lymphomas. Conventional chemotherapy has reached an impasse in efficacy. In B-cell lymphomas, significant improvement in outcome has been achieved with the addition of an anti-cd20 antibody to combination chemotherapy. Since then, various monoclonal antibodies have been developed against lineage-associated antibodies. These antibodies can be naked or conjugated to cellular toxins. The anti-cd30 antibody conjugate brentuximab vedotin is now approved for the treatment of relapsed / refractory Hodgkin lymphoma. It is also effective in the treatment of other CD30-expressing lymphomas, including T-cell lymphomas and NK-cell lymphomas. Other monoclonal antibodies are currently under investigations. The lymphoma microenvironment is important in molding the behavior and response to treatment. The programmed cell death protein ligand 1 (PDL1) and PDL2 are expressed in a variety of lymphomas, particularly Hodgkin lymphoma and Epstein-Barr virus positive lymphomas. In Hodgkin lymphoma, amplification of chromosome 9p24, where the genes for PDL1 and PDL2 are located, is a defining characteristic. Hence, PDL1 and PDL2 over-expression occurs in Hodgkin lymphoma. Two phase 1 studies, involving the use respectively of the anti-pd1 antibodies nivolumab and pembrolizumab, have been conducted in relapsed and refractory Hodgkin lymphomas. The results were very similar, giving an overall response (ORR) of 65-87%, and complete response rates (CR) of 16-17%. PD1 blockade shows variable success in B-cell lymphomas, with ORR of around 30%, and CR rates of 10%. Isolated case series of aggressive B-cell lymphomas and transformed chronic lymphocytic leukaemia have also been reported to respond to PD1 blockade. Preliminary evidence suggests that PD1 blockade may also be effective in NK-cell lymphom Ongoing studies will aim at defining the spectrum of lymphomas that may respond to PD1 blockade. It is also important to define what lymphoma neo-antigens are targeted by rejuvenated T-cells after PD1 blockade. The combination of anti-pd1 antibodies with other medications that may also act on the microenvironment is another focus of research

20 3. Functional genomic approaches in precision oncology: a case study in identifying new therapeutic targets for glioblastoma Patrick Paddison, Fred Hutchison Cancer Research Center, USA Dr. Paddison received his Ph.D. from the Watson School of Biological Science at Cold Spring Harbor Laboratory. His thesis work in Dr. Greg Hannon s lab involved co-opting the RNAi pathway for programmable post-transcriptional gene silencing in mammals, which included development of shrnas, shrna vectors, shrna libraries, and pooled shrna screening techniques. After graduate school, Dr. Paddison accepted a prestigious Cold Spring Harbor Research Fellowship, during which he began applying functional genetic technologies in multiple stem cell systems to identify gene products affecting stem cell self-renewal, differentiation, proliferation, or survival. Since joining Fred Hutchinson Cancer Research Center, Dr. Paddison s cancer-related work has focused on developing patientderived Glioblastoma stem-like cells (GSCs) as a functional genetic system and experimental model of cancer. However, his lab pursues biological questions in multiple human stem cell model systems, including embryonic stem cells, hematopoietic stem and progenitor cells, and neural progenitors. Dr. Paddison has received numerous awards and scholarships for his work, including: the American Cancer Society Research Scholar Award, an Arnold and Mabel Beckman Scholarship, the National Academy of Sciences Kavli Frontiers of Science Scholar Award, a National Science Foundation Undergraduate Research Fellowship, the Pew Scholar Award in Biomedical Sciences, and the National Institute of Health s Ruth L. Kirschstein National Research Service Award. Glioblastoma (GBM) is the most aggressive and common form of adult brain cancer and is among the deadliest cancers, with a median survival of 15 months using standard-of-care therapies. Thus, improved treatments for GBM are desperately needed. To identify new GBM molecular therapeutic targets, our group has performed multiple functional genetic screens in patient-derived GBM stemlike cells (GSCs) and non-transformed human neural stem and progenitor cells, which represent nonneoplastic controls. These screens, which have used both RNAi and CRISPR-Cas9 platforms, have led to the identification of several key molecular vulnerabilities in GSCs, including GBM-specific defects in: 3 splice site recognition, kinetochore function, and loss of redundancy between the kinase activities of PKMYT1 and WEE1. At this meeting, I will present an overview of these studies, as well as our current efforts to: comprehensively retest all GBM-specific vulnerabilities scoring in these screens; address whether vulnerabilities arise from specific genetic alterations in patient samples (e.g., PIK3CA activation vs. PTEN loss); determine whether inhibition of specific molecular targets blocks tumor growth and/or maintenance; and demonstrate the mode of GBM-specific death for particular targets (e.g., cell cycle arrest, apoptosis, etc.). In addition, we will highlight both strengths and limitations of applications of CRISPR-Cas9 technologies in patient samples. Collectively, our work illustrates the power of combining functional genetic technologies with the use of patient isolates to identify novel, patient-specific therapeutic strategies for GBM. The combination of anti-pd1 antibodies with other medications that may also act on the microenvironment is another focus of research

21 4. Radiation and cancer immunotherapy Ramesh Rengan, Department of Radiation Oncology, University of Washington, USA Dr. Ramesh Rengan joined the Department of Radiation Oncology at the University of Washington as an Associate Professor and the Fred Hutchinson Cancer Research Center, Clinical Research Division as an Associate Member in April of 2013 and was appointed as the Medical Director of the SCCA Proton Therapy Center in January He is a graduate of the University of Michigan with an M.D. and Ph.D in Biological Chemistry conferred in He completed his training in Radiation Oncology at Memorial Sloan-Kettering Cancer Center in June of He joined on the faculty of the University of Pennsylvania in 2006 and served as the Chief of the Thoracic service from July of 2010 through April His clinical interests include thoracic malignancies, melanomas, and other solid tumors. Dr Rengan has developed a number of clinical and translational research protocols including recent completion of a phase II therapeutic trial of Nelfinavir with concurrent chemoradiotherapy in locally advanced NSCLC. He serves as principal investigator for an ongoing phase I/II trial examining the role of SBRT in conjunction with ipilimumab for patients with advanced melanoma. His current area of active research interest in collaboration with investigators at UW and FHCRC is to develop an approach to utilize hypofractionated radiation treatment to elicit a tumor-specific immune response in patients with metastatic disease. An area of intense scientific interest is in the exploration of the relationship between the immune system and tumor progression. Multiple studies have demonstrated the importance of the immune system in cancer surveillance and treatment response and the aggressive clinical phenotype of malignancy in an immunocompromised host. This presentation will focus on the utilization of radiation an immune modulator that can augment other cancer immunotherapies in immunocompetent patients with metastatic or oligometastatic disease. We will further discuss the current standard of care in cancer immunotherapy and the strengths and limitations of current approaches. Finally, we will discuss future initiatives aimed at trying to optimize radiation as a tool to generate a durable anti-tumor immune response

22 5. Optimising the management of metastatic renal cancer: translating the evidence into practice John Wagstaff, South West Wales Cancer Institute & Swansea College of Medicine, UK Professor Wagstaff trained as a Medical Oncologist at the Christie Hospital in Manchester. On completion of his training he took up a position as a Senior Lecturer at the Free University Hospital in Amsterdam in In 1994 he was appointed as the Karl Landsteiner Professor of Medical Oncology at the Free University. In 1998 he became Professor & Head of Haematology and Oncology at the University of Maastricht in the Netherlands. Dr Wagstaff is currently Professor of Medical Oncology within the College of Medicine at Swansea University. He is also Director of the Wales Cancer Research Network and Deputy Director of the Wales National Institute for Social Care and Health Research Clinical research Centre (NISCHR-CRC). He is a member of the European Society of Medical Oncology, American Society for Clinical Oncology, Association of Cancer Physicians UK, UK National Cancer Research institute s melanoma and renal cancer clinical study Groups and the European Organisation for Research and Treatment of Cancer. Professor Wagstaff has co-authored over 180 papers in International Peer reviewed journals. His main research interests are renal cancers, melanoma and sarcomas. He is interested in immunotherapy and the interaction between the immune system and the neo-vasculature within tumours. His main focus has been in developing clinical trials for patients with the above diseases and conducting translational research to better understand the effects of new treatments on patients with cancer. Ten years ago the treatment of metastatic renal cell (RCC) was single agent interferon alpha. The response rate was 15% and median overall survival (OS) was bout 11 months. This treatment only improved survival in the Memorial Sloane Kettering Cancer favorable prognosis patients. The realization that the von Hippel Lindau gene was either absent or silenced in RCC and that vascular endothelial growth factor (VEGF) was over-expressed lead to the development of VEGF receptor tyrosine kinase inhibitors sunitinib and pazopanib. Median OS times were increased to 26.4 and 22.9 months respectively and the prospect of prolonged survival became a reality for the first time. The AXIS and RECORD-1 trials demonstrated improvement in progression free survival for axitinib and everolimus but did increase OS compared with sorafenib or placebo. It has long been believed that the immune system interacts with RCC and in the late 1980 s interleukin-2 was shown to produce complete responses in about 10% of patients with 95% or these being alive at ten years. Unfortunately, the toxicity of this therapy precluded its use in all but the very fittest of patients. Recently it has been discovered that many cancers express the programmed death (PD)-1 ligand and the interaction of this ligand with PD-1 on activated cytotoxic T lymphocytes (CTL) down regulates the immune response against the tumour. Nivolumab is a fully humanized monoclonal antibody which blocks the interaction of PD-1 with its ligand and keeps CTL active. This agent has been tested in a randomized trial comparing it with everolimus as a second or third line treatment for metastatic RCC. Response rates were 25 and 2% respectively and OS was significantly longer for nivolumab (25 months) compared with everolimus (19 months). Cabozantinib is an oral, small-molecule inhibitor of tyrosine kinases, including MET, VEGF receptors (VEGFRs), and AXL. MET and AXL are up-regulated in renal-cell carcinoma as a consequence of VHL inactivation, and high expression of each is associated with poor prognosis. This drug has also been compared with everolimus in a randomized clinical trial. Response rates were 21 and 5% respectively and Median OS was also significantly prolonged (21.4 vs 16.5 months). Both the immune checkpoint inhibitors and cabozantinib are being tested as first line therapies. The introduction of these new second and third line treatments promise much for the outcomes of patients with metastatic RCC

23 6. Nano-technologies in cancer diagnostics and therapy Michael Yang, City University of Hong Kong Prof. Yang obtained his Ph.D. from University of Toronto and had postdoctoral training in the Scripps Research Institute, San Diego. He is currently the Head and Chair Professor of Department of Biomedical Sciences, City University of Hong Kong, and the Director of CityU s Shenzhen Biotech Centre. The research interest of Yang s group focuses on the development of biochip technology and nanotechnology for biological research and biomedical applications. He has published over 200 papers in peer-reviewed journals and 23 patents/patent applications, and delivered numerous invited lectures. He holds honorary professorships in Zhejiang University and Third Military Medical University in China. He has been awarded the Chunhui Scholar Award by the Ministry of Education in China in 2003, the K.C. Wong Foundation Award in 2004, the Shenzhen Science and Technology Innovation Award in 2006, and Hong Kong Technological Achievement Grand Award in 2007, and the 2015 Natural Science Award (2nd Prize) of the Ministry of Education of China. Cancer stem cells (CSCs) have been implicated in the recurrence and treatment resistance in many human cancers. Thus, CSC-targeted therapeutic strategies that disrupts the maintenance and survival of CSCs is the subject of active investigation. Nanoparticle-based combinatorial thermotherapy and chemotherapy offers an alternative approach in cancer treatment. We report here on the synthesis and systematic administration of multifunctional silica-based nanoparticles for targeted and combined therapy against a lung cancer model. The silica nanoparticles encapsulating magnetic cores and chemotherapeutic agent were coated with specific antibody against the surface antigen of lung CSCs. The effects of thermotherapy and chemotherapy were induced under an alternating magnetic field (AMF) to trigger heat generation and drug release. Antibody-coated nanoparticles bound specifically to lung CSCs, leading to enhanced cellular uptake in vitro and high accumulation in the tumors in vivo. The use of AMF-induced combined thermotherapy and chemotherapy in vivo significantly suppressed tumor growth in CSC xenograft and in lung metastasis. The survival rate of lung CSCs xenograft-bearing mice was dramatically increased with the nanomedicine treatment. Acknowledgement: This work was supported by the Research Grants Council of Hong Kong, Innovation and Technology Fund of Hong Kong, and the Shenzhen Key Laboratory Funding Scheme of Shenzhen Municipal Government

24 7. Hereditary breast cancer in Hong Kong Ava Kwong, University of Hong Kong Dr. Ava Kwong is the Chief of Breast Surgery Division, Clinical Associate Professor at the University of Hong Kong Medical Centre, Director of the Tung Wah Hospital Breast Centre and Director of Breast Center of University of Hong Kong - Shenzhen Hospital. She is the Assistant Dean (Faculty Advancement and Knowledge Exchange) of Faculty of Medicine, The University of Hong Kong. She is Honorary Consultant in Breast Surgery at Hong Kong Sanatorium and Hospital. She had also held the position of Visiting Associate Professor, Division of Oncology, at the Stanford University, USA from She has been appointed to be the coleader of Cancer Work Group in the development of Cancer Services planning of Hong Kong West Cluster, Hospital Authority in 2012 being responsible in the planning of cancer services for the new development plan of Queen Mary Hospital and cluster. In 2013 she was elected to be the Deputy Chief and Committee Member of the Shenzhen Breast and Endocrine Cancer Society, The People s Republic of China. Aside from her clinical and academic work, she also contributes to the governmental bodies and she has also been appointed to be a member of the Cancer Coordinating Committee of the Food and Health Bureau, Government Secretariat, The Government of the Hong Kong Special Administrative Region, The People s Republic of China in August During her surgical career, she has gained multiple awards including the Hong Kong International Cancer Congress Young Investigator Award in 2006 and 2008 on her research work on breast cancer genetics in Chinese and Asian population, the Breast Surgery International Best Paper Prize, at the International Society of Surgery International Surgical Week meeting in 2007, and a scholarship for undertaking a research fellowship in Breast Cancer Genetics at the Stanford University School of Medicine in Her studies on different aspects of Breast cancer in Chinese women have gained over 100 publications in reputable international journals. She has received various grants to support her research including Hong Kong government based grants such as Food and Health Bureau HHSRF, The Innovation and Technology Fund, Research Grant Council (RGC)/General Research Fund (GRF), and international grants including National Institute of Health in United States of America. In 2015 with School of Public Health of The University of Hong Kong, she has gained a Hong Kong government commissioned grant from Health and Medical Research Fund (HMRF) to study the Risk of Breast Cancer in Hong Kong: Development ad Validation of Risk Prediction Model and Surveillance Study as a Co- Principle Investigator. Mutations due to hereditary related genes such as BRCA1, BRCA2, TP53 and PTEN confer greater risk of developing breast cancer and for BRCA mutations, also ovarian cancer. The risk assessment based on genetic testing allows options of high risk surveillance, prevention and may now also guide use of specific therapies for treatment such as targeted therapies and use of platinum base chemotherapy. There are known ethnic variations in mutation types, prevalence. The choice of management, once an individual has been found to carry the BRCA mutation may also vary. Moreover the availability of genetic testing, method of testing such as the transition into the use of Next Generation Sequencing techniques may also vary in different parts of the world and still have some limitations in some Areas in Asia. The Hong Kong Hereditary Breast Cancer Family Registry was establishment in High risk women based on their age and family history were recruited from both public and private hospitals and clinics of Hong Kong since March Medical information was prospectively collected from the patients and medical records. Epidemiological surveys, choice of management questionnaires were received from each individual. Local data of the Hong Kong Hereditary Breast Cancer Registry and its collaborative work with University of Hong Kong will be shared.

25 8. Liquid biopsies Allen Chan, Chinese University of Hong Kong Professor Chan is serving as a Professor at the Department of Chemical Pathology of The Chinese University of Hong Kong. Allen s main research interest is on the development of innovative diagnostic approaches based on circulating DNA analysis. He developed the first digital PCR based method for the detection of EGFR mutations in the plasma of lung cancer patients. He is a co-inventor of the noninvasive Down syndrome test and developed numerous approaches for the detection of cancers. He is an inventor of over 30 patents families on molecular diagnostics. He has just finished a prospective study on the screening of early nasopharygeal carcinoma in 20,000 asymptomatic men using liquid biopsy. In addition to research, Allen is also passionate about teaching and received a total of four Teacher of the Year awards from the Faculty of Medicine, CUHK. Liquid biopsy which refers to the analysis of circulating DNA released from cancers is gaining importance in the diagnosis and management of cancers. As genetic and genomic changes are present in virtually all cancers, the detection of such changes can potentially be used as a universal tumor marker. In the talk, the application of liquid biopsy for the detection, prognostication and guiding treatment option will be discussed. The result of a prospective cancer screening programme using liquid biopsy will be revealed

26 9. Clinical experience of plasma EGFR testing in lung cancer Y C Li, Queen Elizabeth Hospital Dr. Jacky Li is graduated from The University of Hong Kong. He obtained his fellowship in Clinical Oncology from Hong Kong College of Radiologist in year 2016 and currently works in Queen Elizabeth Hospital, Hong Kong. He is subspecialized in lung cancer treatment and received overseas training with focus on advanced radiotherapy technique on lung cancer from University Hospital Seidman Cancer Centre in Cleveland, Ohio, USA and National Cancer Centre Singapore. He has had active participations in multiple international clinical trials, and submitted abstracts in various international conferences. His current academic interest is in exploring the benefit of novel combination of immunotherapy with radiotherapy in non-small cell lung cancer. Osimertinib was approved by FDA in Nov 2016 for treatment of patients with metastatic EGFR-T790M mutation positive NSCLC, as detected by a FDA-approved test (Cobas EGFR Mutation Test v2) after EGFR-TKI failure, with an ORR up to 70% and a PFS around 11 months. Here we report the experience from Queen Elizabeth Hospital, Hong Kong, on EGFR mutations detected by droplet digital polymerase chain reaction (ddpcr) technique on cell free tumor DNA from lung cancer patients, guiding osimertinib therapy after 1st or 2nd generation TKI failure. All patients with plasma EGFR testing done using ddpcr technique within a certain time frame are retrospectively identified and analyzed. Data will be illustrated and explained during the presentation. A few points will be concluded after analyzing the data. First of all, we suggest testing all patients with radiological or rapid biochemical progression while on 1st or 2nd generation TKI, except those that are deemed to have de novo resistance. The incidence of T790M mutant is low in those we failed to attain clinical benefit, and the typically quoted high incidence (55%-60%) of T790M mutant is in patients who develop resistance defined per Jackman s Criteria. The post-test probability of T790M mutant using plasma EGFR assays depend on the pretest prevalence and the sensitivity of testing assays, which varies with (1) analytical sensitivity of the assays, in descending order: BEAMing, ddpcr, Cobas, and (2) tumor burden (tumor volume, absence or presence of extra-thoracic disease, number of metastatic sites etc.). Secondly, we recommend efforts to obtain tissue biopsy for T790M mutation testing as much as possible for all patients with a negative result from plasma EGFR mutation for T790M. This is especially true if the sensitivity of assay in use is low and the patient has a low tumor burden systemically. A repeated testing of plasma EGFR could be done on further progressive disease and is helpful in patients who declined tissue biopsy or too risky for an invasive biopsy procedure. A positive T790M mutation could be yielded when there is increased tumor burden on progression, apart from the known phenomenon that cfdna is released haphazardly at different time frame. Finally, the quantitative measure of mutant cfdnas could be potentially predictive for treatment response. That would makes us favor the use of ddpcr technique over other qualitative-only assay. In future, we believe a combination of quantitative measure of mutant cfdnas and broad spectrum next-generation-sequencing-based liquid biopsy will fully entertain the clinical needs

27 10. NPC in Hong Kong over previous 60 years Anne Lee, Clinical Professor and Head, Clinical Oncology, University of Hong Kong Prof. Anne Lee is currently the Clinical Professor and Head, Department of Clinical Oncology, The University of Hong Kong. In addition, she is the Chief of Service for the Center of Clinical Oncology at The University of Hong Kong-Shenzhen Hospital in China, and the Chair of Specialty for Oncology at Gleneagles Hong Kong Hospital. She is also the Honorary Consultant, Departments of Clinical Oncology at Queen Mary Hospital and Pamela Youde Nethersole Eastern Hospital in Hong Kong. Currently she is the Vice President of Hong Kong College of Radiologists and the Vice Chairman of Hong Kong Anti-Cancer Society. She also serves in many international academic organizations, including being the Coordinator of the Global Advisory Group and a member of TNM Expert Advisory Panel on Head and Neck Cancers for the Union for International Cancer Control; Vice-Chairman of the National Cancer Staging Committee of China. Prof. Lee s main research contributions focus on nasopharyngeal cancer. She serves in editorial board of many international journals. Currently she is an Associate Editor for Oral Oncology, a member of the Board of Editors for Journal of Clinical Oncology, Radiotherapy & Oncology, and Clinical Oncology. Prof. Lee has received many awards and honors, including the Sir Patrick Manson Gold Medal by The University of Hong Kong in 2008; Gilbert H. Fletcher Distinguished Professor Lecturer by The University of Texas, M.D. Anderson Cancer Center, United States, in 2009; Honorary Membership by the European Society for Radiotherapy & Oncology in 2012; Honorary Membership by the Radiological Society of North America in 2013; and Wharton Lecturer by Princess Margaret Cancer Centre, Canada, in The presentation will include: The evolution in the management of nasopharyngeal cancer in Hong Kong The impact on clinical outcome by improving pattern of care (from diagnostic tests, imaging examinations, radiotherapy technique and dose-fractionation, incorporation of chemotherapy) The contribution to knowledge about epidemiology and possible etiology Furthermore, the lessons learnt from the past experience and how these can contribute to build the future will be discussed

28 11. Translational research in Nasopharygeal carcinoma over 60 years Timothy Yip, Queen Elizabeth Hospital Dr. Yip is in charge of Cancer Research Unit, Clinical Oncology Dept, Queen Elizabeth Hospital, Hong Kong. He obtained B.Sc. in Biochemistry & Immunology in London University & Ph.D. in Tumor Immunology /Virology in Hong Kong University in Dr Yip was attached in Osaka University, Japan & Viral Oncology Division, Institut Gastave-Roussy, France. He is Adjunct Associate Professor in Chinese University of HK & Visiting Professor in Ellis-Fischer Cancer Center, Missouri University, USA from Dr Yip serves as reviewer for a no. of international research journals - Cancer Research, Clinical Cancer Research, Clinical Oncology & Clinical Chemistry & as grant reviewer for Italian Association for Cancer Research & HK University Grant Committee. He is also examiner & training course organizer for Fellowship Exam in Cancer Science in UK Royal College of Radiologists & HK College of Radiologists & examiner for UK Napier University & HK University. He is inventor & holder for US & European patents for lung cancer proteomics biomarkers. He served as Chairman, Section Chairman or Organizing Committee member in various international conferences. The research interests of Dr Yip are in nasopharyngeal cancer, ovary cancer, lymphoma & lung cancer. He makes use of the technologies of viral genetics, genomics & proteomics in diagnosis, prognostication & disease of cancers. His present interest is in the use of viral real time PCR, cdna/cpg island methylation microarray & protein chip in the study of the etiology of carcinogenesis & cancer progression

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