Publications by authors named "Ho Gwo Fuang"

Background: Aspirin is a simple, globally available medication that has been shown to reduce the incidence of colorectal cancer. We aimed to evaluate the safety and efficacy of aspirin in the secondary prevention of colorectal cancer.

Methods: This phase 3, randomised, double-blind, placebo-controlled trial was conducted at 66 centres across 11 countries and territories (ten in Asia-Pacific; one in the Middle East).

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to evaluate the effectiveness of combining pembrolizumab with platinum and gemcitabine (PG) as a first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) in Malaysia, comparing it to the existing treatment with pembrolizumab plus platinum and 5-fluorouracil (PF).
  • It is a phase 2, open-label, multicenter study enrolling up to 89 participants, where pembrolizumab will be administered alongside chemotherapy for six cycles, and various response and safety metrics will be assessed.
  • The trial has received ethical approval and its results will be shared through conferences and scientific publications, aiming to contribute valuable findings to cancer treatment discussions.
View Article and Find Full Text PDF

Background: Cancer-related fatigue and its associated symptoms of sleep disorder and depression are prevalent in cancer survivors especially among breast, lung, and colorectal cancer survivors. While there is no gold standard for treating cancer-related fatigue currently, studies of mind-body exercises such as Qigong have reported promise in reducing symptoms. This study was designed to evaluate the feasibility and effect of Guolin Qigong on cancer-related fatigue and other symptoms in breast, lung and colorectal cancer survivors while exploring their perceptions and experiences of Guolin Qigong intervention.

View Article and Find Full Text PDF
Article Synopsis
  • Afatinib can be safely started at doses lower than the standard 40 mg/day for treating non-small cell lung cancer (NSCLC) with EGFR mutations, but its effectiveness in real-world settings needed examination.
  • A study involving 133 NSCLC patients in Malaysia found that lower doses (below 40 mg) had a higher objective response rate (72.3%) compared to the standard dose (54.0%).
  • Although patients on lower doses were more likely to respond to treatment, the overall median survival was similar, indicating potential benefits without compromising safety.
View Article and Find Full Text PDF

Uterine leiomyosarcomas (ULMS) are a rare cause of uterine malignancy. Due to their aggressive nature, resistance to standard therapy and high rates of recurrence, they are associated with a very poor prognosis, irrespective of their stage at diagnosis. A 68-year-old female, Chinese patient was diagnosed with Stage IVB uterine leiomyosarcoma with lung metastasis.

View Article and Find Full Text PDF
Article Synopsis
  • Cemiplimab shows significant survival benefits for patients with advanced non-small-cell lung cancer that have high PD-L1 expression, with 1-year follow-up results revealed last year.
  • The EMPOWER-Lung 1 trial involved 712 patients, who were given either cemiplimab or chemotherapy, as part of a randomized, phase 3 study focusing on treatment effectiveness and safety.
  • After 35 months, the study continued to assess patient outcomes, specifically how adding chemotherapy could impact those whose cancer worsened while on cemiplimab treatment.
View Article and Find Full Text PDF

Purpose: This survey was conducted to assess the current research practices among the 14 members of the Federation of Asian Organizations for Radiation Oncology (FARO) committee, to inform measures for research capacity building in these nations.

Materials And Methods: A 19-item electronic survey was sent to two research committee members from the 14 representative national radiation oncology organizations (N = 28) that are a part of FARO.

Results: Thirteen of the 14 member organizations (93%) and 20 of 28 members (71.

View Article and Find Full Text PDF

Overgrowth of Candida yeasts in the oral cavity may result in the development of oral thrush in immunocompromised individuals. This study analyzed the diversity and richness of the oral mycobiota of patients clinically diagnosed with oral thrush (OT), follow-up of oral thrush patients after antifungal therapy (AT), and healthy controls (HC). Oral rinse and oral swab samples were collected from 38 OT patients, 21 AT patients, and 41 healthy individuals (HC).

View Article and Find Full Text PDF
Article Synopsis
  • - The study compares the cardiac safety and effectiveness of a trastuzumab biosimilar (SB3) to the original trastuzumab (TRZ) for treating ERBB2-positive breast cancer over a follow-up period of up to 6 years.
  • - Conducted from April 2016 to January 2021, the trial included 538 female patients, with both treatment groups receiving neoadjuvant chemotherapy followed by adjuvant therapy, and monitored for heart-related side effects.
  • - Primary outcomes measured were cardiac issues like heart failure and reduced left ventricular function, with secondary outcomes focusing on event-free and overall survival rates between the two treatment options.
View Article and Find Full Text PDF

Aim: The OPTIM1SE study observed long-term real-world outcomes of cetuximab-based infusional 5-fluorouracil (5-FU) regimens for first-line treatment of metastatic colorectal cancer (mCRC) across Asia-Pacific and Middle East regions, aiming to characterize their use, effectiveness, and safety in routine practice.

Methods: OPTIM1SE was a prospective, open-label, observational study. Patients with untreated KRAS wild-type mCRC and distant metastases were treated per locally approved labels and monitored for 3 years via electronic medical records.

View Article and Find Full Text PDF
Article Synopsis
  • Anaplastic lymphoma kinase (ALK) inhibitors are effective for ALK-positive metastatic non-small cell lung cancer (NSCLC), but access is limited in developing countries like Malaysia due to financial constraints.
  • A study analyzed 65 ALK-positive NSCLC patients from 18 Malaysian hospitals, finding that most received crizotinib, the most common ALK inhibitor, and showed improved overall survival (OS) compared to those on chemotherapy.
  • Although ALK inhibitors led to a longer median time on treatment (TOT) and OS, the results were not statistically significant likely due to the small sample size.
View Article and Find Full Text PDF

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 (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma.

View Article and Find Full Text PDF

Purpose: We evaluated the efficacy and safety of pembrolizumab in patients from Asia with previously treated advanced hepatocellular carcinoma (HCC).

Methods: In a double-blind, phase III trial, 453 patients with advanced HCC and progression during or after treatment with or intolerance to sorafenib or oxaliplatin-based chemotherapy were randomly assigned in a 2:1 ratio to receive pembrolizumab (200 mg) or placebo once every 3 weeks for ≤ 35 cycles plus best supportive care. The primary end point was overall survival (one-sided significance threshold, = .

View Article and Find Full Text PDF

Background: Quality of life (QOL) of family caregivers of cancer patients is usually affected due to increase in caregiver burden. Their QOL has not garnered much attention by many including the health professionals and community. This study aims to explore the QOL of family caregivers of cancer patients in a multi-ethnic country in Asia and to investigate its associate factors.

View Article and Find Full Text PDF

Background: Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector.

Methods: Data were derived from 20 focus group discussions that were conducted in five public and private Malaysian hospitals, which included 102 adults with breast, cervical, colorectal or prostate cancers.

View Article and Find Full Text PDF

Cancer-associated thrombosis (CAT) poses a significant disease burden and the incidence in Asian populations is increasing. Anticoagulation is the cornerstone of treatment, but can be challenging due to the high bleeding risk in some cancers and the high risk of recurrent venous thromboembolism (VTE) in patients with malignancies. Direct oral anticoagulants (DOACs) are well established as first-choice treatments for VTE in non-cancer patients, offering a more convenient and less invasive treatment option than low-molecular-weight heparin (LMWH).

View Article and Find Full Text PDF

Purpose: This study aims to describe the adverse events following immunization (AEFIs) of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.

Methods: A cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) before and after the first and second doses of COVID-19 vaccine.

View Article and Find Full Text PDF

Background: Although first- and second-generation EGFR TKIs are considered first-line treatment in EGFRm+ NSCLC, most patients develop resistance and progress, commonly, EGFR mutation. The third-generation EGFR-TKI has demonstrated efficacy in patients with progressive disease harboring the mutation and in the first-line setting, bypassing this mode of resistance. The primary objectives of this study are to describe the proportion of m+ NSCLC patients treated with first-, second- and third-generation EGFR TKIs, and cytotoxic chemotherapy in the first-line setting, and the time on treatment for each category.

View Article and Find Full Text PDF

Introduction: Immune checkpoint inhibitor (ICI) therapy is an established treatment for advanced non-small-cell lung cancer (NSCLC) and programmed death ligand-1 (PD-L1) expression is a recognized biomarker to determine response to therapy. We retrospectively analyzed NSCLC patients in the Malaysia Lung Cancer Registry (MLCR) and report on the clinical characteristics associated with PD-L1 expression and ICI use in Malaysia, a low- to middle-income country.

Methods: All 901 NSCLC patients in the MLCR who were diagnosed from January 1, 2017 to December 31, 2020 from 14 hospitals across the country were analyzed.

View Article and Find Full Text PDF

: Despite the increasing treatment options for patients with metastatic breast cancer (MBC), unmet needs remain common, especially in low and middle-income countries where resources are limited and MBC patients face many challenges. They often join support groups to cope with their unmet needs. Currently, many MBC patients connect with each other via online support group in view of the constant availability of support and rapid information exchange.

View Article and Find Full Text PDF

The development of resistance to tyrosine kinase inhibitors (TKIs) in metastatic non-small cell lung cancer (NSCLC) with oncogenic driver mutations highlights the challenge in improving the survival of these patients. The standard of care for ALK-rearranged advanced NSCLC refractory to various generations of ALK TKIs falls back to the use of chemotherapy and the prognosis remains poor. We report the case of a 41-year-old lady with an ALK-translocated metastatic lung adenocarcinoma, who demonstrated good response to an immune checkpoint inhibitor, atezolizumab in combination with bevacizumab and chemotherapy (pemetrexed and carboplatin), following disease progression on three generations of ALK TKIs.

View Article and Find Full Text PDF

Context: Numerous studies have shown that gratitude can reduce stress and improve quality of life.

Objective: Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer.

Methods: We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia.

View Article and Find Full Text PDF

The development of resistance to trastuzumab in HER2-positive gastroesophageal cancer remains a problem. The use of dual HER2 blockade to overcome this is a therapeutic strategy that should be researched more extensively.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the emotional distress and unmet support needs of cancer survivors in Malaysia, highlighting the challenges faced in resource-limited settings where cancer care services are inadequate.
  • Focus group discussions with 102 cancer patients revealed that distress stems from both direct stressors (like side effects and fear of recurrence) and indirect stressors (like financial issues and lack of practical support), with women expressing unique emotional needs.
  • Although informal support from family and friends is prevalent, the lack of professional emotional support and services is a significant gap, emphasizing the need for actionable changes to enhance the emotional wellbeing of cancer survivors in the region.
View Article and Find Full Text PDF

Background: Identifying patients with mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming.

View Article and Find Full Text PDF