CUHK Leading the Combat against Asian Prevalent Cancers
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​Leading the Combat against ​Asian Prevalent Cancers

According to the World Health Organization, cancer is the second leading cause of death globally, accounting for 9.6 million deaths in 2018. Standing at the forefront of cancer research in Asia, the Chinese University of Hong Kong (CUHK) is a leader in the combat against the most lethal and prevalent cancers in the region, including gastrointestinal cancers, nasopharyngeal cancer, lung cancer and liver cancer.
 
CUHK has been pushing the research frontiers of these deadly diseases by synergising its capacity, research strengths and talent across multiple disciplines. The CUHK Faculty of Medicine, the two State Key Laboratories in Translational Oncology and in Digestive Disease 
hosted at the University as well as many non-medical research disciplines are working closely together to advance cancer research and treatment, resulting in a number of internationally recognised "world’s first" and ground-breaking discoveries.
 
Leading researchers at CUHK have received numerous accolades worldwide in recognition of their invaluable contributions, such as world’s Top 20 Translational Researchers by Nature Biotechnology and Lifetime Achievement Award by the European Society for Medical Oncology. The University has also demonstrated its significant academic impact, reflected in the many notable publications of its scholars which are highly cited in academia.
 
The University also works with leading institutions and national cancer centres regionally and globally to advance cancer research and treatment. With an extended collaborative network and multi-disciplinary teams, CUHK is primed to assume a leading role and committed to upholding its strong track-record in cancer research and care, advancing its understanding of different cancers and translating scientific findings into meaningful clinical outcomes for cancer patients. 

CUHK’s Landmark Discoveries and Breakthroughs in
​Four Asian Prevalent Cancers

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Gastrointestinal Cancers
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Teams of researchers at CUHK are tirelessly dedicating their efforts in developing ways of early detection, diagnosis, and treatment to battle gastrointestinal (GI) cancers. GI cancers, which include gastric (stomach), colorectal and liver cancers, constitute about 40% of all malignancies diagnosed in the Chinese population and are the leading cause of mortality in Hong Kong. 

Advancing Scientific Knowledge and Clinical Diagnosis of Gl Cancers
​Pioneering Minimally Invasive Surgery for Cancer Treatment
Improving Safety and Cost-effectiveness of Colonoscopy
​Uncovering the Secrets of Stomach Infections towards Cancer​
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Advancing Scientific Knowledge and Clinical Diagnosis of GI Cancers

Professor Joseph Sung and Professor Jun Yu of the Institute of Digestive Disease and State Key Laboratory of Digestive Disease have led some of the most ground-breaking discoveries of gastrointestinal (GI) cancers at CUHK:

  • New ways to predict survival outcomes: With the application of next-generation sequencing, the research team has identified novel recurrently mutated genes in colorectal cancer (CRC) and a prognostic mutation signature that predicts survival outcomes of CRC patients independent of tumour-node-metastasis staging.
 
  • Potential non-invasive early diagnosis and therapeutic targets: The research team has also identified novel oncogenes and tumour suppressors in GI carcinogenesis, gene markers for potential non-invasive early diagnosis of GI cancers, and potential therapeutic targets such as SLC12A5, SLC25A22 and SQLE. Inhibitors that can suppress the function of these therapeutic targets have been developed.
 
  • Advanced research on microbiome in GI cancers: CUHK is at the forefront of international research into the biology and applications of gut microbiota in GI cancers. The University is among the first institutions worldwide to demonstrate the ectopic overgrowth of oral pathogens in CRC and gastric cancer, the pro-tumourigenic role of faecal samples from CRC patients, the oncogenic mechanisms of specific microbes, and the use of faecal microbes as non-invasive diagnostic markers for CRC.
 
  • Translation of research findings into clinical applications: The identification of stool-based microRNA biomarkers such as miR-135b and miR-92a has led to the pioneering development of a screening kit approved by the former China Food and Drug Administration for the non-invasive early detection of CRC. A blood-based methylated-DNA biomarker (RNF180) was also identified previously and led to the development of a kit for the non-invasive detection of gastric cancer.
 
  • Research breakthroughs: Further studies on gastric cancer have led to the discovery of novel gene mutations and epigenetic alterations linked to Epstein-Barr virus (EBV)-associated gastric carcinogenesis, detection of new tumour-suppressor genes and potential prognostic biomarkers associated with gastric cancer, and identification of a novel mutational signature which offers the opportunity to stratify gastric cancer patients into optimal treatment plans based on molecular subtyping.
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Professor Joseph Sung
Institute of Digestive Disease
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​Professor Jun Yu
Institute of Digestive Disease
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CUHK is leading the battle against GI cancers through advanced research. 
Pioneering Minimally Invasive Surgery for Cancer Treatment

A cross-disciplinary team of CUHK medical researchers successfully conducted the world’s first multi-specialty clinical trial using a next generation single port robotic surgical system on the feasibility and safety in three different surgical specialties, including otorhinolaryngology, head and neck surgery; urology; and colorectal surgery. By minimising the number of external abdominal incisions, single port surgery (surgery performed through one external incision) and natural orifice transluminal endoscopic surgery (NOTES, surgery performed by inserting an endoscope through a natural orifice such as the mouth or the anus and creating an incision inside the body) can theoretically reduce patient trauma, enhance recovery, and improve cosmesis.

​For colorectal surgery, the low external profile of this new robotic platform and the possibility of deployment through a single access site can facilitate single port transabdominal surgeries such as colectomy, and NOTES such as transanal robotic surgery.
 
The novel system also allows surgeons to reach deep spaces previously difficult to reach, like the nasopharynx and the hypopharynx, to carry out delicate procedures with precision. 

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​(From left)
Professor Philip Chiu and Professor Simon Ng
Department of Surgery
Dr. Jason Chan
Department of Otorhinolaryngology, Head and Neck Surgery
Professor Anthony Ng and Professor James Lau
Department of Surgery
Improving Safety and Cost-effectiveness of Colonoscopy

​With an aim to improve the safety and cost-effectiveness of colonoscopy, one of the most effective ways to prevent colorectal cancer, a team of CUHK researchers, coordinated by Professor Carmen Poon of the Department of Surgery, has developed a real-time computer-aided diagnosis system, AIdoscopist, for polyp localisation and classification during colonoscopy. The system displays the diagnosed result of each polyp to doctors in real time and assists doctors in making instant decision of whether a polyp should be resected or not. 

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CUHK is committed to improving safety and cost-effectiveness of colonoscopy. 
Uncovering the Secrets of Stomach Infections towards Cancer

Infection of Helicobacter pylori (H. pylori) in the stomach is a major cause of gastric cancer. In order to further understand the mechanism of H. pylori infections and help future development of novel drugs against it, a research team led by Professor Kam-Bo Wong of the School of Life Sciences has discovered how H. pylori can survive in the stomach by using a toxic metal, nickel ions, to activate an enzyme that can neutralise gastric acid.​

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​Professor Kam-Bo Wong (left)
School of Life Sciences
Further readings:
  • Four CUHK Researchers Receive China's Excellent Young Scientists Fund 2019
  • Professor Yu Jun Honoured with The Ho Leung Ho Lee Foundation Prize for Progress in Science and Technology
  • CUHK Study Sees Increasing Global Incidence of Colorectal Cancer Among Younger People
  • Yu Jun Takes on Colon Cancer
  • The Silent Battle Against Bowel Cancer - Martin Wong on Early Detection and Prevention
  • CUHK-DGIST-ETH Zurich Establish Joint Laboratory on Nano-technology for Gastrointestinal and Cardiovascular Diseases
  • Evaluation of Traditional Chinese Medicine in Cancer Treatments
Nasopharyngeal Cancer
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Nasopharyngeal cancer (NPC) is a common cancer in southern China and Southeast Asia. It is far less common in the West: in 2014, the age-standardised incidence rate was 7.9 per 100,000 in Hong Kong, but less than 1.0 per 100,000 in North America and Europe. CUHK is a leader in NPC research with its ground-breaking discoveries becoming standards in NPC testing and therapy. The University is also the world’s first institution to report the whole genome map of NPC, significantly improving scientific understanding of the cancer.
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​Setting the Standard in NPC Care
Facilitating Early NPC Diagnosis with Non-Invasive Blood Test
​World’s First Mapping of Whole Genome of NPC
Improving Survival Rate of NPC
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Setting the Standard in NPC Care

Studies by Professor Anthony Chan of the Department of Clinical Oncology and State Key Laboratory of Translational Oncology established a chemo-radiotherapy regimen that significantly improved overall survival compared with radiotherapy alone, and together with the multi-disciplinary team, developed the intensity-modulated radiation therapy technique which led to excellent local tumour control and has become the standard of care in nasopharyngeal cancer (NPC) for more than a decade.


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​Professor Anthony Chan
Department of Clinical Oncology
​Facilitating Early NPC Diagnosis with Non-Invasive Blood Test

A non-invasive DNA blood test developed by Professor Dennis Lo of the Department of Chemical Pathology and State Key Laboratory of Translational Oncology, first applied to prenatal diagnosis of Down syndrome, has been applied to the detection of nasopharyngeal cancer (NPC) by measuring fragments of circulating Epstein-Barr virus (EBV) DNA with high sensitivity and specificity. The test has proven to be useful for early NPC detection which could significantly improve treatment outcome. It may also be used to evaluate treatment response, help stratify patients based on disease risk and guide personalised treatment strategy accordingly, which is important to improve outcome in some patients and prevent unnecessary treatment-related toxicities in others. This blood test has received international recognition and has become a standardised test in the National Cancer Institute in the US.​

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The non-invasive blood test developed by Professor Dennis Lo has been applied to the detection of NPC.
World’s First Mapping of Whole Genome of NPC

CUHK is the world’s first institution to report the whole genome map of nasopharyngeal cancer (NPC) and propose a progressive multi-step carcinogenic model for the cancer starting with Epstein-Barr virus (EBV) infection, allowing better understanding of cancer biology and translation of research findings into clinical applications. This landmark accomplishment has since been recognised internationally and has led to the identification of proteins involved in the NF-κB inflammatory pathway that may serve as novel therapeutic target in NPC.
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The whole genome of NPC was first mapped by CUHK.
Improving Survival Rate of NPC

An international landmark study led by Professor Brigette Ma and Professor Anthony Chan of the Department of Clinical Oncology and Professor Kwok Wai Lo of the Department of Anatomical and Cellular Pathology reveals that immune-checkpoint inhibitor is effective in patients with advanced nasopharyngeal cancer (NPC). Results show the 1-year overall survival rate was around 60%. Further analysis facilitates the identification of biomarkers and the development of immunotherapy in NPC patients.​

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CUHK research reveals that immunotherapy has clinically meaningful and durable activity in some NPC patients.
Further readings:
  • Two CUHK Scholars Named World’s “Top 20 Translational Researchers”; Professor Dennis Lo Receiving the Honour for the Third Consecutive Year
  • CUHK Receives Two Ministry of Education Higher Education Outstanding Scientific Research Output Awards
  • Two CUHK Research Papers on Lung Cancer and Nasopharyngeal Cancer Selected as “Most Notable” by NEJM
Lung Cancer
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Lung cancer has been the first leading cause of cancer death in Hong Kong for many years, accounting for 27.1% of all the city’s cancer death in 2017. It is also the most common and deadliest cancer in the world, with 2.09 million new cases and 1.76 million deaths in 2018. Significant progress has been made in lung cancer research by CUHK. The University’s landmark discoveries of key biomarkers have changed the standard practice in lung cancer treatment, helped guide therapeutic decisions and improved disease outcome in lung cancer patients.
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Advancing Lung Cancer Research
Killing Cancer with Microwaves
Diagnosing Lung Cancer with Artificial Intelligence​
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Advancing Lung Cancer Research

​​A major study led by Professor Tony Mok of the Department of Clinical Oncology discovered that the presence of epidermal growth factor receptor (EGFR) mutation in patients with lung adenocarcinoma is a strong predictor of better treatment outcome with EGFR inhibitor. A second generation targeted therapy shows a more than 7-month improvement in the overall survival of advanced non-small-cell lung cancer (NSCLC) patients with EGFR mutation, compared with conventional first-line treatment. More details

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Earlier on, Professor Mok set the new standard of care for anaplastic lymphoma kinase (ALK)-positive lung cancer patients throughout the world by confirming a novel targeted therapy which is twice as effective as the standard treatment because it doubles the progression-free survival time, and at the same time, lowers the chance of brain metastases. More details​

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CUHK sets global standards in lung cancer treatment. 
​More recently, studies from the State Key Laboratory of Translational Oncology, led by Professor Ka Fai To of the Department of Anatomical and Cellular Pathology in collaboration with Professor Mok, identified additional oncogenic mutations in lung cancer patients (i.e. ALK and MNNG-HOS transforming [MET]) which could serve as useful biomarkers for guiding treatment strategy.
 
While the presence and potential clinical implications of MET mutations in lung cancer are being further investigated, Professor To’s team became the first to comprehensively analyse the spectrum of MET mutations in different types of lung cancer. It was found that a subgroup of lung cancer (sarcomatoid carcinoma) has a high prevalence of MET mutations that can be targeted with currently available therapies. By identifying patients with these mutations earlier, greater therapeutic benefits can be achieved.
Killing Cancer with Microwaves

The first-ever non-invasive lung cancer ablation surgery in hybrid operating room utilising microwaves in Asia-Pacific was performed by Professor Calvin Ng and Dr. Rainbow Lau of the Department of Surgery in 2019. By means of electromagnetic navigation bronchoscopy and cone-beam computed tomography guidance, surgeons can deploy the microwave catheter tip for ablation into the lung cancer and raise the surrounding temperature to above 60°C to destroy the lesion. The non-invasive surgery leaves no scars and incurs almost no blood loss. With a low risk of complications, the procedure takes only 10 to 20 minutes and most patients feel no pain afterwards. As of March 2020, the team has performed over 30 surgeries, representing the largest samples in the world. It is also the co-investigator of the first multi-centre international clinical study (NAVABLATE trial).​

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Professor Calvin Ng (left) and Dr. Rainbow Lau (right)
Department of Surgery
Diagnosing Lung Cancer with Artificial Intelligence​

Professor Pheng-Ann Heng and Professor Qi Dou of the Department of Computer Science and Engineering have developed an innovative artificial intelligence system through deep learning based on automated medical image analysis technologies to offer accurate and efficient diagnosis using volumetric CT scans and large-scale histopathological images. The system has been validated on lung cancer as well as breast cancer, two of Hong Kong’s most prevalent cancers.​

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​Professor Qi Dou (left) and Professor Pheng-Ann Heng (right)
Department of Computer Science and Engineering
Further readings:
  • Professor Tony Mok Honoured with the ESMO Lifetime Achievement Award; Recognising His Global Leadership in Defining Lung Cancer Treatment Standard
  • ​CUHK Receives an International Cancer Care Team Award Nominated by Patients
  • Two CUHK Research Papers on Lung Cancer and Nasopharyngeal Cancer Selected as “Most Notable” by NEJM
Liver Cancer
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Most of the world’s liver cancer cases occur in Asia, accounting for around 80% of all cases worldwide. About half of these cases appear in China alone. CUHK’s research in liver cancer has led to novel ways of detection and treatment, as well as enhanced understanding of the disease.

​Identifying Therapeutic Targets against Liver Cancer
Calculating the Risk of Liver Cancer in Hepatitis B Patients
Discovering Liver Cancer Genes with Machine Learning
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​Identifying Therapeutic Targets against Liver Cancer

Clinical management of patients with hepatocellular carcinoma (HCC, the most common type of liver cancer) remains a challenge. The prevailing conjectures of intratumour heterogeneity and divergent clonal lineage are the root of clinical concerns. A team led by Professor Nathalie Wong of the Department of Surgery has deciphered the pattern of clonal divergence in HCC at both the genetic and epigenetic levels. Knowledge gained has laid the basis for their on-going work in identifying therapeutic targets against this difficult-to-treat malignancy.

​To facilitate the clinical translation of laboratory findings to new drug discoveries, the team has recently established patient-derived HCC organoids that maintain patients' genomic trait and clonal heterogeneity ex-vivo. These models represent a reliable resource for drug targeting activities.
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Professor Nathalie Wong
Department of Surgery
Calculating the Risk of Liver Cancer in Hepatitis B Patients

A team of hepatology researchers comprising Professor Henry Chan, Professor Vincent Wong and Professor Grace Wong of the Department of Medicine and Therapeutics have pioneered to develop scoring systems that help estimate the likelihood of a patient developing liver cancer using routine clinical and laboratory parameters since 2010. With the availability of transient elastography, a non-invasive measure of liver fibrosis, the accuracy of the scoring system to predict liver cancer is further optimised. These scoring systems have been validated in overseas centres in Asia and North America.

The test, designed for patients who have chronic hepatitis B, would increase the chance of early treatment of liver cancer. The scoring system is particularly useful for family doctors, facilitating them to determine the patients to be sent to specialists for closer monitoring and consideration of antiviral therapy. The team has also collaborated with various international centres to develop and validate cancer risk scores among patients on antiviral therapy to streamline the strategy of liver cancer surveillance.
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CUHK pioneers scoring systems to estimate the likelihood of a patient developing liver cancer.
Discovering Liver Cancer Genes with Machine Learning

Three genes that could be related to the development of liver cancer have been identified by a cross-disciplinary collaboration between Professor Kevin Yip of the Department of Computer Science and Engineering and Professor Alfred Cheng of the School of Biomedical Sciences. By using machine learning to incorporate a vast amount of data, the research studied gene enhancers, a type of regulatory element in DNA, together with their target genes, in 935 human cell and tissue samples. Aimed to explain the consequences of perturbations in enhancers, the genes, namely PSRC1, RBM24 and TERT, were found to be differentially methylated at their enhancer regions in liver cancers.

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With the help of machine learning, CUHK researchers have identified genes that could be related to the development of liver cancer.
Further readings:
  • CUHK Study Proves Ablative Chemoembolisation Doubles the Progression-Free Survival for Liver Cancer Patients
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CUHK actively pursues collaborations with institutions around the world. 
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