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Lam TC, Cho WCS, Au JSK, Ma ESK, Lam STS, Loong HHF, Wong JWH, Wong SM, Lee VHF, Leung RCY, Lau JKS, Kam MTY, Mok FST, Lim FMY, Nyaw JSF, Tin WWY, Cheung KM, Chan OSH, Kwong PWK, Cheung FY, Poon DM, Chik JYK, Lam MHC, Chan LWC, Wong SCC, Cao YB, Hui CV, Chen JZJ, Chang JH, Kong SFM, El Helali A. Consensus Statements on Precision Oncology in the China Greater Bay Area. JCO Precis Oncol 2023; 7:e2200649. [PMID: 37315266 PMCID: PMC10309548 DOI: 10.1200/po.22.00649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/31/2023] [Accepted: 04/19/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Next-generation sequencing comprehensive genomic panels (NGS CGPs) have enabled the delivery of tailor-made therapeutic approaches to improve survival outcomes in patients with cancer. Within the China Greater Bay Area (GBA), territorial differences in clinical practices and health care systems and strengthening collaboration warrant a regional consensus to consolidate the development and integration of precision oncology (PO). Therefore, the Precision Oncology Working Group (POWG) formulated standardized principles for the clinical application of molecular profiling, interpretation of genomic alterations, and alignment of actionable mutations with sequence-directed therapy to deliver clinical services of excellence and evidence-based care to patients with cancer in the China GBA. METHODS Thirty experts used a modified Delphi method. The evidence extracted to support the statements was graded according to the GRADE system and reported according to the Revised Standards for Quality Improvement Reporting Excellence guidelines, version 2.0. RESULTS The POWG reached consensus in six key statements: harmonization of reporting and quality assurance of NGS; molecular tumor board and clinical decision support systems for PO; education and training; research and real-world data collection, patient engagement, regulations, and financial reimbursement of PO treatment strategies; and clinical recommendations and implementation of PO in clinical practice. CONCLUSION POWG consensus statements standardize the clinical application of NGS CGPs, streamline the interpretation of clinically significant genomic alterations, and align actionable mutations with sequence-directed therapies. The POWG consensus statements may harmonize the utility and delivery of PO in China's GBA.
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Affiliation(s)
- Tai-Chung Lam
- Department of Clinical Oncology, Queen Mary Hospital/Hong Kong University-Shenzhen Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Joseph Siu-Kie Au
- Adventist Oncology Centre, Hong Kong Adventist Hospital, Hong Kong SAR, China
| | - Edmond Shiu-Kwan Ma
- Clinical and Molecular Pathology and Cancer Genetics Centre, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | - Stephen Tak-Sum Lam
- Clinical Genetic Service Centre, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | - Herbert Ho-Fung Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason Wing Hon Wong
- School of Biomedical Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - S.N. Michael Wong
- Department of Clinical Oncology, Queen Mary Hospital/Hong Kong University-Shenzhen Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Victor Ho-Fun Lee
- Department of Clinical Oncology, Queen Mary Hospital/Hong Kong University-Shenzhen Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | | | - Michael Tsz-Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | | | - Fiona Mei-Ying Lim
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | | | | | - Ka-Man Cheung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | | | | | - Foon-Yiu Cheung
- Hong Kong International Oncology Centre, Hong Kong SAR, China
| | - Darren M.C. Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | | | | | - Lawrence Wing-Chi Chan
- Department of Health Technology & Informatics, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Sze-Chuen Cesar Wong
- Department of Health Technology & Informatics, Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ya-Bing Cao
- Department of Radiology & Oncology, Kiang Wu Hospital, Macao SAR, China
| | - Cheng-Vai Hui
- Department of Clinical Oncology, Centro Hospitalar Conde de São Januário, Macao SAR, China
| | - Jack Zhi-Jian Chen
- Department of Radiation Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China
| | - Jian-Hua Chang
- Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China
| | - Spring Feng-Ming Kong
- Department of Clinical Oncology, Queen Mary Hospital/Hong Kong University-Shenzhen Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Aya El Helali
- Department of Clinical Oncology, Queen Mary Hospital/Hong Kong University-Shenzhen Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Nyaw JSF, Cheung KM, Hioe F, Kam MTY, Lau JKS, Lau YM, Leung DKC, Lim FMY. Best practices in epidermal growth factor receptor T790M testing for advanced non-small-cell lung cancer in Hong Kong. Hong Kong Med J 2023; 29:240-246. [PMID: 37349139 DOI: 10.12809/hkmj219632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
The T790M mutation in the epidermal growth factor receptor gene causes most acquired resistance to firstor second-line epidermal growth factor receptor-tyrosine kinase inhibitors in advanced non-small-cell lung cancer. The results of T790M testing can guide subsequent treatment. Despite the availability of guidelines from international organisations, T790M testing practices in Hong Kong must be streamlined and adapted to the Hospital Authority setting. To address this issue, a panel of experts in oncology and pathology met for discussion of key topics regarding T790M testing practices in Hong Kong, including the appropriate timing of testing and re-testing, as well as optimal testing methods. All panel members voted on the results of the discussion to achieve consensus. Items supported by a majority vote were adopted as consensus statements regarding current best practices for T790M testing in Hong Kong. Among the topics discussed, the panel agreed that T790M testing should be initiated upon radiological progression, including symptomatic disease progression or central nervous system-only progression. The experts also preferred initial testing with liquid biopsy, using the widely available digital polymerase chain reaction platform. This document provides the final consensus statements, as well as a testing and treatment workflow, for clinicians in Hong Kong to use as guidance in T790M testing.
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Affiliation(s)
- J S F Nyaw
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR, China
| | - K M Cheung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - F Hioe
- Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - M T Y Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - J K S Lau
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong SAR, China
| | - Y M Lau
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, China
| | - D K C Leung
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong SAR, China
| | - F M Y Lim
- Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China
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Chan W, Nyaw JSF, Tin WWY, Lee EKC, Lo SH, Liu ACH, Wong FCS. Risk of Radiation Pneumonitis after Post-lobectomy Thoracic Radiotherapy for Non-small-cell Lung Cancer. Hong Kong Journal of Radiology 2020. [DOI: 10.12809/hkjr2017084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- W Chan
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - JSF Nyaw
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - WWY Tin
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - EKC Lee
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - SH Lo
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - ACH Liu
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - FCS Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
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