Victor Ho Fun Lee

• MBBS, MD, FRCR, FHKCR, FHKAM
• Professor (Associate) at The University of Hong Kong

Patients with acquired immunocompromising conditions face considerable risk of developing herpes zoster (HZ). Based on the underlying medical conditions and degree of immune dysfunction, these patients require tailored strategies for HZ prevention. In Hong Kong, there is currently a lack of guidelines addressing the unique needs of this vulnerable...

We developed a named entity (NE) framework for information extraction from semi-structured clinical notes retrieved from The Cancer Genome Atlas-Thyroid Cancer (TCGA-THCA) database and examined Large Language Models (LLMs) strategies to classify the 8th edition of American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (A...

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual pr...

Importance Accurate staging is a fundamental step in treating patients with nasopharyngeal carcinoma (NPC) worldwide; this is crucial not only for prognostication, but also for guiding treatment decisions. The American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) system is the global lan...

Background In advanced-stage hepatocellular carcinoma (HCC) management, sorafenib remains an important option for patients who are ineligible for alternative treatments. Despite clinical evidence indicating that sorafenib may affect the efficacy of subsequent anti-PD-1 therapy, nivolumab is currently administered after sorafenib tolerance in variou...

Purpose Bodyweight loss is a common occurrence in Nasopharyngeal Carcinoma (NPC) patients during Radiotherapy (RT). Previous studies found that the prognostic value of percentage weight loss (pWL) during RT is not credible. We aimed to develop a novel progression predictor surrogated to pWL by modelling all bodyweight records measured during the tr...

This BMP2 is an indispensable gene in bone development and repair across vertebrates. The relation between BMP2 expression level and tumor genesis/progression has been reported previously. In this study, we use The Cancer Genome Atlas datasets (TCGA) to explore possible effect of BMP2 in different tumors. Among many tumor types in TCGA datasets, BM...

Background Direct oral anticoagulants (DOACs) have demonstrated clinical benefits and better patient adherence over low-molecular-weight heparin (LMWH) in treating patients with cancer-associated venous thrombosis (CAT). We aimed to compare the cost-effectiveness of DOACs against LMWH in patients with CAT from the perspective of the Hong Kong healt...

Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 pa...

Low-dose computed tomography (LDCT) image reconstruction techniques can reduce patient radiation exposure while maintaining acceptable imaging quality. Deep learning is widely used in this problem, but the performance of testing data (a.k.a. target domain) is often degraded in clinical scenarios due to the variations that were not encountered in tr...

Metastasis is the biggest obstacle to esophageal squamous cell carcinoma (ESCC) treatment. Single‐cell RNA sequencing analyses are applied to investigate lung metastatic ESCC cells isolated from pulmonary metastasis mouse model at multiple timepoints to characterize early metastatic microenvironment. A small population of parental KYSE30 cell line...

Importance Whether stereotactic body radiotherapy (SBRT) as a bridge to liver transplant for hepatocellular carcinoma (HCC) is effective and safe is still unknown. Objective To investigate the feasibility of SBRT before deceased donor liver transplant (DDLT) for previously untreated unresectable HCC. Design, Setting, and Participants In this phas...

12045 Background: The survival rate of patients with nasopharyngeal cancer (NPC) has significantly improved in the last decade. However, there are only a few studies that have quantified the long-term morbidity and mortality that follow NPC treatment. This study aims to analyze the chronic health conditions, all-cause mortality, and cause-specific...

e15174 Background: Large population-based comprehensive tumor genomic profiling using next-generation sequencing (NGS) technology offers insight into the detection of copy number variation (CNV) in advanced/metastatic solid cancers. However, the significance and role of CNV in advanced-stage non-small cell lung cancer (NSCLC) is limited. In this an...

8019 Background: Recent studies on the perioperative treatment of Non-Small Cell Lung Cancer (NSCLC) have often excluded patients with stage IA. To address this issue and bridge the knowledge gap, we aim to investigate the impact of PD-L1 and EGFR status on survival in stage IA NSCLC. Methods: Our study aimed to determine the impact of PD-L1 expres...

Background & Aims Combined ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-acetate (dual-tracer) positron-emission tomography/computed tomography (PET/CT) is being increasingly performed for the management of hepatocellular carcinoma (HCC), although its role is not well defined. Therefore, we evaluated its effectiveness in (i) staging, (ii) characterization o...

Simple Summary Nasopharyngeal carcinoma (NPC) is an epithelial cancer associated with Epstein–Barr virus (EBV) infection. EBV infection contributes to not only the tumorigenesis of NPC but also the formation of a complicated tumor immune microenvironment (TIME) in NPC. Natural killer (NK) cells are lymphoid members of the innate immune system exhib...

Background: Nasopharyngeal carcinoma (NPC) has a high incidence rate in Southeast Asia, where more than 90% of NPC cases are associated with Epstein-Barr virus (EBV). Although NPC patients are generally sensitive to radiotherapy and chemotherapy, about 20-30% of patients have treatment failure due to the development of distant metastasis, i.e. de n...

Generalizable medical image segmentation enables models to generalize to unseen target domains under domain shift issues. Recent progress demonstrates that the shape of the segmentation objective, with its high consistency and robustness across domains, can serve as a reliable regularization to aid the model for better cross-domain performance, whe...

Background Time‐resolved magnetic resonance fingerprinting (MRF), or 4D‐MRF, has been demonstrated its feasibility in motion management in radiotherapy (RT). However, the prohibitive long acquisition time is one of challenges of the clinical implementation of 4D‐MRF. The shortening of acquisition time causes data insufficiency in each respiratory p...

In this study, we developed a trusted federated learning framework (FL-TrustVCE) for multi-institutional virtual contrast-enhanced MRI (VCE-MRI) synthesis. The FL-TrustVCE is featured with patient privacy preservation, data poisoning prevention, and multi-institutional data training. For FL-TrustVCE development, we retrospectively collected MRI dat...

Simple Summary One of the questions that experts are trying to answer about COVID-19 is whether it will have a positive or negative effect on cancer. It is important to consider the added risk of COVID-19 symptoms when making decisions about cancer treatments. To gain a deeper understanding of this, we discussed the relationship between COVID-19 an...

This study aims to investigate the clinical efficacy of AI generated virtual contrast-enhanced MRI (VCE-MRI) in primary gross-tumor-volume (GTV) delineation for patients with nasopharyngeal carcinoma (NPC). We retrospectively retrieved 303 biopsy-proven NPC patients from three oncology centers. 288 patients were used for model training and 15 patie...

Simple Summary Common central venous access devices (CVADs) include peripherally inserted central catheters (PICCs), central lines, and totally implanted ports (PORTs). Studies have shown PORTs have the least catheter-related complications, while PICCs are associated with the highest risk. The delivery of systemic anticancer therapy is known to be...

Introduction: Plasma Epstein-Barr virus (EBV) DNA has been shown to be a sensitive and specific biomarker for prognosis, surveillance of recurrence, and treatment response of nasopharyngeal cancer (NPC). The phase 3 KEYNOTE-122 trial (NCT02611960) was conducted to evaluate pembrolizumab (pembro) vs standard of care (SOC) chemotherapy (chemo) in pat...

Background Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and present...

Recently, deep learning has been demonstrated to be feasible in eliminating the use of gadolinium-based contrast agents (GBCAs) through synthesizing gadolinium-free contrast-enhanced MRI (GFCE-MRI) from contrast-free MRI sequences, pro-viding the community with an alternative to get rid of GBCAs-associated safety issues in patients. Nevertheless, g...

Purpose: Although several agents targeting epidermal growth factor receptor (EGFR) exon 20 insertions (ex20ins) have recently been approved by the US Food and Drug Administration, toxicities related to the inhibition of wild-type (WT) EGFR are common with these agents and affect overall tolerability. Zipalertinib (CLN-081, TAS6417) is an oral EGFR...

Purpose: Although systemic treatment is the mainstay for advanced hepatocellular carcinoma (HCC), numerous studies have highlighted the added value of local treatment. This study aimed to investigate the clinical efficacy of liver-directed combined radiotherapy (LD combined RT) compared with that of sorafenib, a recommended treatment until recentl...

Purpose: This study aimed to discover intra-tumor heterogeneity signature and validate its predictive value for adjuvant chemotherapy (ACT) following concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Materials and methods: 397 LA-NPC patients were retrospectively enrolled. Pre-treatment contrast-en...

Background: The meta-analysis of chemotherapy for nasopharynx carcinoma (MAC-NPC) collaborative group previously showed that the addition of adjuvant chemotherapy to concomitant chemoradiotherapy had the highest survival benefit of the studied treatment regimens in nasopharyngeal carcinoma. Due to the publication of new trials on induction chemoth...

e15161 Background: CD8 ⁺ T lymphocytes are believed to be the major anti-tumor immune subsets. Consequently, most cancer immunotherapeutic approaches seek to amplify cytotoxic T lymphocytes specific to malignant cells. A recently identified subpopulation of memory CD8 ⁺ T cells, named tissue-resident memory T (Trm) cells, persists in non-lymphoid t...

6035 Background: Epstein-Barr Virus (EBV) is associated with a diverse collection of malignancies, including nasopharyngeal carcinoma (NPC). One viral-encoded protein, EBNA1, is consistently expressed in all known EBV-associated malignancies and is critical for the replication and maintenance of the EBV genome in latently infected cells. VK-2019 is...

e14622 Background: Anti-programmed cell death protein-ligand 1 (PD-L1) monotherapy has not shown promising anti-tumor effects in recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) in first-line settings. Consequently, second-generation checkpoint inhibitors via targeting multiple pathways are urgently needed. Bintrafusp alfa (also known as M78...

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...

Background and purpose: Physiological changes in tumour occur much earlier than morphological changes. They can potentially be used as biomarkers for therapeutic response prediction. This study aimed to investigate the optimal time for early therapeutic response prediction with multi-parametric magnetic resonance imaging (MRI) in patients with nas...

Lung adenocarcinoma is the most common type of lung cancer. Known risk variants explain only a small fraction of lung adenocarcinoma heritability. Here, we conducted a two-stage genome-wide association study of lung adenocarcinoma of East Asian ancestry (21,658 cases and 150,676 controls; 54.5% never-smokers) and identified 12 novel susceptibility...

Nasopharyngeal carcinoma (NPC), with the highest incidence and prevalence in Southern China including Hong Kong, originates from the nasopharyngeal epithelium and frequently metastasises to cervical lymph nodes and distal organs such as liver. Radiation therapy with/without concurrent chemoradiation is the most common first-line treatment. Although...

Introduction: The immunosuppressive tumor microenvironment is a major barrier for chemotherapy. Different chemosensitization approaches to reinstate immunological surveillance for cancers that are immune quiescent at the outset, have thus been devised. Cancer-specific ENOX2 expression is correlated with abnormal cell growth and has been proposed a...

Objective: We sought to identify predictors of delayed viral clearance in cancer patients with asymptomatic COVID-19 when the SARS-CoV-2 omicron variants prevailed in Hong Kong. Methods: All cancer patients attending radiation therapy for head and neck malignancies or systemic anti-cancer therapy saved their deep-throat saliva or nasopharyngeal...

Purpose: To develop a respiratory-correlated four-dimensional imaging technique based on magnetic resonance fingerprinting (MRF), i.e., RC-4DMRF, for liver tumor motion management in radiotherapy. Methods: Thirteen liver cancer patients were prospectively enrolled in this study. k-space MRF signals of the liver were acquired during free-breathin...

Background: The integration of next-generation sequencing (NGS) comprehensive gene profiling (CGP) into clinical practice is playing an increasingly important role in oncology. Therefore, the HKU-HKSH Multi-disciplinary Molecular Tumour Board (MTB) was established to advance precision oncology in Hong Kong. A multicenter retrospective study invest...

The study aimed to develop liquid biopsy assays for early hepatocellular carcinoma (HCC) diagnosis and prognosis. The study is the first to integrate circulating miRNAs, AST, ALT, AFP, and machine learning for predicting DFS in early HCC patients undergoing hepatectomy.

Study objectives: To examine the trajectories of sleep disturbance in cancer survivors during the first two years post-treatment and to investigate whether psychological, cognitive and physical factors differentiate trajectories. Methods: A total of 623 Chinese cancer survivors of diverse cancer types participated in a 2-year-long prospective st...

Introduction: Lorlatinib is a potent, third-generation inhibitor of ALK. In the planned interim analysis of the ongoing, phase 3, randomized, global CROWN trial (NCT03052608), lorlatinib resulted in significantly longer progression-free survival than crizotinib in patients with previously untreated, advanced, ALK-positive NSCLC. Here, we present a...

Purpose: This study aims to develop liquid biopsy assays for early HCC diagnosis and prognosis. Methods: Twenty-three microRNAs were first consolidated as a panel (HCCseek-23 panel) based on their reported functions in HCC development. Serum samples were collected from 103 early-stage HCC patients before and after hepatectomy. Quantitative PCR and...

565 Background: While systemic treatment is the mainstay for advanced hepatocellular carcinoma (HCC), numerous studies have highlighted the added value of local treatment. This study aimed to investigate the clinical efficacy of liver-directed combined radiotherapy (LD-CRT) compared to sorafenib, a recommended treatment until recently in locally ad...

Background and purpose: To investigate the radiomic feature (RF) repeatability via perturbation and its impact on cross-institutional prognostic model generalizability in Nasopharyngeal Carcinoma (NPC) patients. Materials and methods: 286 and 183 NPC patients from two institutions were included for model training and validation. Perturbations wi...

Background and aims: Deregulation of adenosine-to-inosine (A-to-I) editing by adenosine deaminase acting on RNA 1 (ADAR1) leads to tumor-specific transcriptome diversity with prognostic values for hepatocellular carcinoma (HCC). However, ADAR1 editase-dependent mechanisms governing liver cancer stem cell (LCSC) generation and maintenance have rema...

This study aims to investigate the feasibility of improving the prognosis stratification of the N staging system of Nasopharyngeal Carcinoma (NPC) from quantitative spatial characterizations of metastatic lymph node (LN) for NPC in a multi-institutional setting. A total of 194 and 284 NPC patients were included from two local hospitals as the disco...

Hepatocellular carcinoma (HCC) is a major public health burden in Hong Kong, and chronic hepatitis B is the most common HCC etiology in our region. With the high case load, extensive local expertise on HCC has been accumulated. This article summarized local guidelines and real-life practice on HCC management in Hong Kong. For HCC surveillance, live...

Background In the global REACH-2 study, ramucirumab significantly improved overall survival (OS) compared with placebo in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha-fetoprotein (AFP). REACH-2 China study aimed to evaluate the efficacy and safety of ramucirumab in Chinese patients with advanced HCC (NCT02435433). Metho...

Background Epstein-Barr virus (EBV) latent infection is associated with genome-wide epigenomic changes in several malignancies, but its role in epigenetic dysregulation remains unclear in nasopharyngeal carcinoma (NPC). Methods To investigate EBV-associated epigenetic dysregulation, we performed a multi-omics study by integrating whole-genome bisu...

The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus...

Background: Pembrolizumab previously demonstrated robust antitumor activity and manageable safety in a phase Ib study of patients with heavily pretreated, PD-L1-positive, recurrent or metastatic nasopharyngeal carcinoma (NPC). The phase III KEYNOTE-122 study was conducted to further evaluate pembrolizumab versus chemotherapy in patients with plati...

Radiotherapy with electrons is commonly applied to the tumor bed after whole-breast radiotherapy following breast conservation surgery for breast cancer patients. However, the radiation dose to adjacent organs-at-risk (OARs) and conformity of planning target volume (PTV) cannot be optimized. In this study, we examine the feasibility of using modula...

p>In this study, we aimed at investigating generalizability of GFCE-MRI model using data from seven institutions by manipulating heterogeneity of training MRI data under two popular normalization approaches. A multimodality-guided synergistic neural network (MMgSN-Net) was applied to map from T1-weighted and T2-weighted MRI to contrast-enhanced MRI...

Background Using high robust radiomic features in modeling is recommended, yet its impact on radiomic model is unclear. This study evaluated the radiomic model’s robustness and generalizability after screening out low-robust features before radiomic modeling. The results were validated with four datasets and two clinically relevant tasks. Material...

p>In this study, we aimed at investigating generalizability of GFCE-MRI model using data from seven institutions by manipulating heterogeneity of training MRI data under two popular normalization approaches. A multimodality-guided synergistic neural network (MMgSN-Net) was applied to map from T1-weighted and T2-weighted MRI to contrast-enhanced MRI...

p>In this study, we aimed at investigating generalizability of GFCE-MRI model using data from seven institutions by manipulating heterogeneity of training MRI data under two popular normalization approaches. A multimodality-guided synergistic neural network (MMgSN-Net) was applied to map from T1-weighted and T2-weighted MRI to contrast-enhanced MRI...

We attempted to investigate the Radiomic feature (RF) repeatability and its agreements across imaging modalities and head-and-neck cancer (HNC) subtypes via image perturbations. Contrast-enhanced computed tomography (CECT), CET1-weight, T2-weight magnetic resonance images of 231 nasopharyngeal carcinoma (NPC) patients, and CECT images of 399 oropha...

The purpose of this study is to investigate the model generalizability using multi-institutional data for virtual contrast-enhanced MRI (VCE-MRI) synthesis. This study presented a retrospective analysis of contrast-free T1-weighted (T1w), T2-weighted (T2w), and gadolinium-based contrast-enhanced T1w MRI (CE-MRI) images of 231 NPC patients enrolled...

Background/Purpose The Asian Liver Radiation Therapy Study Group has formed a large and detailed multinational database of outcomes following stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). Here, we explored the potential impact of HCC etiology on SBRT efficacy. Tumor control probability (TCP) models were established...

(1) Background: Randomized controlled trials (RCTs) have explored various primary treatments for individuals diagnosed as having later-stage epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer. Nevertheless, the extent to which such treatments are efficacious, particularly with regard to overall survival (OS) rates of patient...

(1) Background: SMARCB1 (INI-1)-deficient sinonasal carcinoma is a rare sinonasal malignancy; since its discovery and description in 2014, less than 200 cases have been identified. It is almost impossible to perform randomized-controlled trials on novel therapy to improve treatment outcomes in view of its rarity. We performed a systematic review of...

Background: Hepatocellular carcinoma (HCC) is one of the most common and most difficult to cure malignancies worldwide. Identifying new effective therapeutic targets is of great significance for the management of HCC. Cumulative evidence suggests cancer stem cells (CSCs) are key drivers of tumor growth and heterogeneity. Post-transcriptional RNA ed...