Most Read Articles
Prof. Charlie Gourley, 30 Sep 2020

First-line poly(ADP-ribose)polymerase (PARP) inhibitor maintenance therapy significantly increases progression-free survival (PFS) in high-grade ovarian cancer patients. However, questions remain regarding the ability of PARP inhibitors to increase the cure rate, the types of patients most likely to benefit from them, and when it is best to employ them. In a virtual small-group meeting with experts in Hong Kong, Professor Charlie Gourley of the University of Edinburgh, Edinburgh, UK discussed the criteria for optimal patient selection and the positioning of PARP inhibitors in the patient journey.

Dr. Herman Sung-Yu Liu, 03 Aug 2020
Although first- and second-generation tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukaemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL), resistance or intolerance to these agents has limited their effectiveness, particularly in patients who harbour the BCR-ABLT315I mutation. In an interview with MIMS Oncology, Dr Herman Sung-Yu Liu, Specialist in Haematology & Haematological Oncology in private practice in Hong Kong, discussed the management of CML and Ph+ ALL using the third-generation TKI, ponatinib, the only agent in its class with activity against the T315I mutation. 
Dr. Kathleen Moore, 30 Sep 2020
Most patients with advanced ovarian cancer (OC) relapse after standard cytoreductive surgery and platinum-based chemotherapy. At a webcast organized by the Hong Kong Society of Clinical Oncology, Dr Kathleen Moore of the University of Oklahoma in Norman, Oklahoma, US, discussed the results of the SOLO-1 trial, which demonstrated significant progression-free survival (PFS) benefits associated with maintenance therapy using the poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitor, olaparib, in patients with newly diagnosed, advanced BRCA-mutated OC who had complete or partial response (CR/PR) to first-line platinum-based chemotherapy. 
05 Aug 2020
With ageing populations, many countries face increasing healthcare demands associated with the management of diseases and comorbidities common among the elderly, such as cancer, osteoarthritis and rheumatoid arthritis, and the pain associated with these conditions. In recent years, there has been growing evidence supporting the use of sustained-release (SR) oxycodone (OxyContin®, Mundipharma) as a pain management option for elderly patients, particularly those experiencing chronic cancer-related pain. This article summarizes the key points and evidence from two seminal papers – a consensus statement of an international expert panel on opioids and the management of chronic severe pain in the elderly as well as a multicentre, open-label randomized controlled trial investigating the efficacy and safety of SR oxycodone in cancer pain treatment. 

Laparoscopic gastrectomy comparable to open gastrectomy for gastric cancer

Dr Margaret Shi
05 Oct 2020

Laparoscopic gastrectomy (LG) offers comparable outcomes to open gastrectomy (OG) even in patients with advanced tumours, results of a recent study involving 294 gastric cancer patients in Hong Kong have shown.

“This is the first report assessing the safety and efficacy of LG for gastric cancer in a tertiary referral centre in Hong Kong. The results showed no significant differences in postoperative complications and mortality between LG and OG, supporting the use of LG for patients with gastric cancer, including those with advanced cancer,” the researchers noted. [Surg Oncol 2020;35:14-21]

The retrospective longitudinal study included gastric cancer patients with histologically confirmed adenocarcinoma without distant metastasis, who underwent primary radical gastrectomy with either LG (n=157; male, 66.2 percent) or OG (n=137; male, 73.7 percent) in Queen Mary Hospital between January 2008 and December 2015. Propensity score (PS) matching was done to reduce the effect of selection bias on the surgical approach and potential confounding factors.

Result showed higher rates of limited lymphadenectomy (D0, D1, D1+) with OG than LG (31.4 percent vs 7.6 percent; p<0.66), given that D1+ lymphadenectomy was performed as the standard operating procedure for proximal gastrectomy and OG was the treatment preference for difficult and unfavourable conditions, such as adhesions from previous surgery. Significantly more combined resections, which included the gallbladder, transverse colon or mesentery, were performed in patients undergoing OG vs LG (38 patients vs 4 patients; 27.5 percent vs 2.5 percent; p<0.01).

Although the mean surgical time was significantly increased with LG vs OG (294.7 minutes vs 231.8 minutes; p<0.01) in the PS-matched cohort, LG was associated with a significant reduction in mean estimated blood loss (191.6 mL vs 351.0 mL; p=0.01). Other surgical outcomes, including the need for intraoperative blood transfusion, resection margins, number of lymph nodes examined and duration of postoperative hospital stay, were comparable between groups.

Patients who underwent OG had more intraoperative complications, such as spleen laceration, than those who underwent LG (9.3 percent vs 0 percent; p=0.06), but rates of postoperative complications were not significantly different between the groups, 40.7 percent vs 35.2 percent; p=0.69). Rates of 30-day and 90-day mortality were similar between the OG and LG groups (30-day mortality, 0 percent vs 0 percent) (90-day mortality, 3.7 percent vs 1.9 percent; p=1.00), with comparable Clavien-Dindo gradings for surgical complications (p=0.58).

Significant differences in pathological characteristics, in terms of tumour size, lymphovascular invasion, pT stage, pN stage, surgical margins and use of adjuvant chemotherapy, were observed between the LG and OG groups (all p<0.05).

At a median follow-up of 48 months, comparable rates of 3-year overall survival (OS) and disease-free survival (DFS) were reported with LG vs OG (3-year OS rate, 64.8 percent vs 55.6 percent; p=0.34) (3-year DFS rate, 61.1 percent vs 55.6 percent; p=0.51). The surgical approach (ie, OG vs LG) had no influence on patients’ survival outcomes. 

Disease recurrence within 3 years of surgery occurred in 20 patients in the OG group and 11 patients in the LG group, respectively, with a significantly greater number of OG- vs LG-treated patients having peritoneal recurrences within 3 years of surgery (15 vs 2; p<0.01).

Despite the high volume of surgical cases in Hong Kong every year, only 60–70 gastrectomies are performed annually. In Queen Mary Hospital, LG is mostly indicated in cases of distal gastrectomy, patients with earlier-disease stage, and those without combined resection of other organs.

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Most Read Articles
Prof. Charlie Gourley, 30 Sep 2020

First-line poly(ADP-ribose)polymerase (PARP) inhibitor maintenance therapy significantly increases progression-free survival (PFS) in high-grade ovarian cancer patients. However, questions remain regarding the ability of PARP inhibitors to increase the cure rate, the types of patients most likely to benefit from them, and when it is best to employ them. In a virtual small-group meeting with experts in Hong Kong, Professor Charlie Gourley of the University of Edinburgh, Edinburgh, UK discussed the criteria for optimal patient selection and the positioning of PARP inhibitors in the patient journey.

Dr. Herman Sung-Yu Liu, 03 Aug 2020
Although first- and second-generation tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukaemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL), resistance or intolerance to these agents has limited their effectiveness, particularly in patients who harbour the BCR-ABLT315I mutation. In an interview with MIMS Oncology, Dr Herman Sung-Yu Liu, Specialist in Haematology & Haematological Oncology in private practice in Hong Kong, discussed the management of CML and Ph+ ALL using the third-generation TKI, ponatinib, the only agent in its class with activity against the T315I mutation. 
Dr. Kathleen Moore, 30 Sep 2020
Most patients with advanced ovarian cancer (OC) relapse after standard cytoreductive surgery and platinum-based chemotherapy. At a webcast organized by the Hong Kong Society of Clinical Oncology, Dr Kathleen Moore of the University of Oklahoma in Norman, Oklahoma, US, discussed the results of the SOLO-1 trial, which demonstrated significant progression-free survival (PFS) benefits associated with maintenance therapy using the poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitor, olaparib, in patients with newly diagnosed, advanced BRCA-mutated OC who had complete or partial response (CR/PR) to first-line platinum-based chemotherapy. 
05 Aug 2020
With ageing populations, many countries face increasing healthcare demands associated with the management of diseases and comorbidities common among the elderly, such as cancer, osteoarthritis and rheumatoid arthritis, and the pain associated with these conditions. In recent years, there has been growing evidence supporting the use of sustained-release (SR) oxycodone (OxyContin®, Mundipharma) as a pain management option for elderly patients, particularly those experiencing chronic cancer-related pain. This article summarizes the key points and evidence from two seminal papers – a consensus statement of an international expert panel on opioids and the management of chronic severe pain in the elderly as well as a multicentre, open-label randomized controlled trial investigating the efficacy and safety of SR oxycodone in cancer pain treatment.