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HKU and Queensland researchers make nasopharyngeal carcinoma (NPC) treatment breakthrough

01 Feb 2012

 

The accumulation of 10 years of collaborative research between scientists from The University of Hong Kong Li Ka Shing Faculty of Medicine and the Australian Centre for Vaccine Development at the Queensland Institute of Medical Research (QIMR) has led to a significant breakthrough in the treatment of nasopharyngeal carcinoma (NPC), an aggressive Head and Neck cancer with a high prevalence in Hong Kong.  By offering targeted immune treatment, the team was able to increase the median time of patient survival from 200 to over 500 days in the phase I study, which is an encouraging result.  The result of the research has just been published in the latest issue of the leading scientific journal - Cancer Research.  The team is planning to validate these preliminary findings further.

About the study

"NPC is associated with Epstein-Barr virus (EBV) infection in a manner analogous to the association of hepatitis B virus and liver cancer.  By using adoptive immunotherapy, the human body's own immune system was used to successfully fight against the disease." says Professor Dora KWONG Lai-wan, Head of Department of Clinical Oncology, The University of Hong Kong Li Ka Shing Faculty of Medicine.

The presence of EBV in the cancer cells gives the body's immune system a definite target to help battle against the NPC, resulting in minimal side effects, as suggested by Professor John Malcolm NICHOLLS, Clinical Professor of the Department of Pathology, The University of Hong Kong Li Ka Shing Faculty of Medicine.  This is a phase I study examining the safety and tolerability of the adoptive immunotherapy (T-cell infusion) on recurrent and metastatic NPC patients, and is a joint project between the HKU and the QIMR researchers.  Dr. Janice TSANG Wing-hang, Clinical Assistant Professor in the Department of Clinical Oncology reported that the results of this study showed that the treatment was well-tolerated by the patients without much side effects and by enhancing the immune cells of the NPC patients, this has doubled the overall survival time of the late-stage NPC patients, results yet need to be further validated.  Patients who participated in the trial were having locally recurrent or metastatic NPC and were usually quite unwell, so it was important to ensure the treatment was non-invasive, non-toxic and did not damage any healthy cells.

Research Methodology

14 NPC patients were treated at the Department of Clinical Oncology, Queen Mary Hospital (the teaching hospital of HKU) in Hong Kong from August 2008 to April 2010 and the trial has recently been expanded to the Princess Alexandra Hospital in Brisbane. 

Blood was taken from NPC patients in Hong Kong then transported to QIMR in Australia where the white blood cells (lymphocytes) were grown and trained to specifically recognise EBV infected cancer cells.  These trained immune cells were then returned back to Hong Kong and infused into the patients where they would selectively kill EBV infected cancer cells - also referred as "adoptive immunotherapy".  The patients were then closely monitored and followed up for any side effects by oncologists at the Queen Mary Hospital.

Major results

Among the 14 patients treated  at the Queen Mary Hospital in Hong Kong, the majority were male patients, aged from 37 to 60.  This novel immunotherapy was prepared at QIMR in Brisbane using the Q-Gen which was a fully-integrated facility for translational research within QIMR. The research team there was headed by Professor Rajiv Khanna.  By offering such targeted treatment, the mean time to progression (TTP) for these cancer patients was 136 days, and the median overall survival of the patients who received the T-cell infusion was 523 days compared to 220 days for those who did not receive the T-cell infusion.  This is indeed an encouraging result, serving as the foundation for future directions.  The study team believes that if this treatment is to be offered to patients with earlier stages of NPC, accompanied with the standard chemotherapy and radiation, it might further enhance the overall outcome of NPC patients in the future, yet results to be confirmed.

The way forward

HKU and QIMR will be continuing their collaboration and further investigation of immunotherapy for the treatment of NPC patients.

About the research team

This study is the joint effort of both the HKU researchers and the QIMR researchers, including the Department of Clinical Oncology and Department of Pathology at the University of Hong Kong, and the Australian Centre for Vaccine Development at the Queensland Institute of Medical Research.  This phase I study was conducted during August 2008 - April 2010 with the results just being published in Cancer Research recently.

The University of Hong Kong (HKU) Li Ka Shing Faculty of Medicine is the longest established faculty in the tertiary education in Hong Kong, which was founded in 125 years ago.  The Faculty is dedicated to innovative research with high scientific and translational values, thereby contributing to the development of Hong Kong into a biomedical research hub of the region.  The results of the research work of Faculty members are published in distinguished international journals.  48 of the Faculty members are listed among the top 1% of scientists in their fields, according to the 2011 ISI's Essential Science Indicators.

For more information about HKU LKS Faculty of Medicine, please visit:
http://www.med.hku.hk/

The Queensland Institute of Medical Research (QIMR) is a world leading translational research institute.  Their research focuses on cancer, infectious diseases, mental health and a range of complex disorders.  Working in close collaboration with clinicians and other research institutes, the aim of QIMR is to improve health by developing new diagnostics, better treatments and prevention strategies.

For more information about QIMR, visit http://www.qimr.edu.au/

About Nasopharyngeal Carcinoma (NPC)

Nasopharyngeal Carcinoma (NPC) is one of the top 10 cancers in Hong Kong, ranking 6^th among male, and 7^th for both male and female, with about 900 new cases in 2009 according to the latest Hong Kong Cancer Registry, which is more common in men.  NPC is also known as "Canton Tumour", as it is very common in the Guangdong province.  It occurs in about 25 cases per 100,000 people in the Guangzhou region, 25 times higher than the rest of the world.  This could be due to the South East Asian diet, which typically includes consumption of salted vegetables, fish and meat.  There is also a genetic predisposition to NPC and exposure to EBV early in life may predispose to this tumour. 

(From left) Professor John Malcolm NICHOLLS, Clinical Professor of the Department of Pathology, The University of Hong Kong Li Ka Shing Faculty of Medicine, Professor Dora KWONG Lai-wan, Head of Department of Clinical Oncology, The University of Hong Kong Li Ka Shing Faculty of Medicine and Dr. Janice TSANG Wing-hang, Clinical Assistant Professor in the Department of Clinical Oncology, The University of Hong Kong Li Ka Shing Faculty of Medicine


The flow chart illustrates the flow of the treatment. The E1-LMPoly in the graphic refers to EBV antigens.