Saturday, November 28, 2015

What I Learnt from Phase 1 Conference?

I always feels that international conference is very much different than local conference, in the sense that the talks and speeches are on their work, unlike local ones which sometimes talk on the textbook content.

And so with a bit of luck, I had the chance to go to ICPOEP - International Conference on Phase 1 and Early Phase Clinical Trials in Hong Kong.

All the way from Seberang Jaya at Grand Hyatt Hotel, TST defined Phase 1 as studies that are usually conducted with healthy volunteers and that emphasize safety. The goal is to find out what the drug's most frequent and serious adverse events are and, often, how the drug is metabolized and excreted.

Of course, the obligatory photo as a traveler in Hong Kong
This conference is organised by Clinical Trial Centre, University of Hong Kong. As you can see, their's is a bit different setup from ours in Clinical Research Centre, Malaysia. They are part of the university and their hospital is part of the university.

There is a section displaying their trial set up. There is a large picture of the view from clinical trial ward. The hospital which houses the trial ward is overlooking ocean view of Hong Kong. They make the subjects feel that they are on Holiday rather than coming in for Research. Basic amenities such as soaps, shampoos, slippers are Hotel-like, and menu of the food there is extremely attractive!

Each of them given this starterpack. Note that there is an IPAD with entertainment, something like flight entertaiment concept.
Macam Hotel
Menu. Ganas.
The talk started right on time. Good organisation I would say. The list of speakers were impressive. Mostly were Chinese names based in overseas, renowned medical centres, like Ninewells Dundee, NUS Singapore, Imperial London, Uni of Toronto Canada, Harvard just to name a few.

I took pictures of almost all slides to keep me awake throughout the sessions, and for the purpose of this entry, for my goldfish memory. I'll share some slides which are very interesting, at least to me.

Let me start with this Prof Gail Echardt's talk on challenges and opportunities in early phase trial. She was given an award lecture in Drug Development in this annual conference. She is a very established early phase researcher from Colorado, USA. She shared her experience in organising her Phase 1 centres, particularly her strategies in nurturing new researchers and going away from MD-driven hierarchy. 

I particularly like this slide. She showed that there is a disease specific team leader and coordinator which oversees the Phase 1 study, specifically on that disease, and they typically follow through as the study progresses to Phase 2 and 3. 
Let me just say that in this slide, the last sentence is the killer!
I think I will not be able to go in depth in all talks. 

Let me move on to my favourite speaker, Prof Lee M Ellis. His CV is long, but for the sake of his speech, suffice to know that he is a journal editor. He talked about research integrity. 

He talked about increasing occurrence of fraud and dishonesty in research conduct. He feels that this is all because of academic pressure which is unnecessary. He gave examples of Japanese Riken scientists and Anil Potti in Duke. 

I think it is very relevant to us, in Malaysia whereby the push for publication is high, but without proper mentoring. There is a very high pressure on us to perform. In that process, it is important to keep in mind that we do not sway from good research integrity, attempted plagiarism, sloppy reporting, dishonesty and academic bullying.

I would think most of us are Sloppy, but hopefully we dont Fabricate.
I have nothing to publish in CNS. LOL
It is funny when some proposals I was told that was rejected previously because it has been done. Our top level needs to know the importance of reproduciblity of any research to test the hypothesis repeatedly. We learnt to do more, as we done more.
I would love to see this kind of fresh talk in NCCR.

OK, lets move to a intellectual talk. This Prof Mak Tak-Wah, is extremely funny man. I think he is damn old, probably in his 70s and his job is just travelling around the world giving speech. Despite his age you see, he is given a topic - Future Oncology Targets, just to show how big is his name in advanced research of Oncology. He basically went through from historical perspective on how unsuccessful our endeavors in coming out with new oncology drugs, mainly because we had the wrong conception. But right now, there are many new targets being pursued, which his lab is working on, and he even shared a slide of which it has just been published on that day itself.

New targets, note the footnote. The conference was on 19/11/15 - it was just published today
Warburg is a Nobel Prize winner who said Cancer is not caused by Virus or genes, both very wrong. But we progress not because scientists changed their minds, but because they die. Scientists - sometimes, over-believed their science.
Note that Prof Mak is the main author!
Other interesting speakers and slides:

 This was Prof Swanton's talk on  Cancer Evolution and Implications to research. Oncology which have seen past 12 years of research producing 72 FDA approved drugs with 52 new targeted approaches but only producing meagre 2.1 months of improved overall survival. 
How stagnant is our research progress and yet we we think we have progressed very much.

I think this is an exceptionally good topic. Prof Plesner gave a talk of his entire journey with Daratumumab, a new therapy for Multiple Myeloma. He was there in the Phase 1 trial in his Hematology Unit and Clinical Research Unit and all the way right up to Marketing. Such a complete research story to share.
Dr Chan Wing-Kai is a very outspoken person. He gave a brief outline of clinical trial in Taiwan. More like an advertisement type of talk, he told us the strength of Taiwan Clinical Research. But I took one point from him very deeply, is that if you want to be the boss, you must have gone through the entire process, A to Z, and keep youself involved in the entire process, and then you can be the BOSS. Taiwan is very far ahead of us in Clinical Trial, mainly because they have such competitive character like Dr Chan.
From Singapore, we have Danny Soon, well known figure in the field of clinical research South East Asia. Very straight to the point and motivated person, he is an example why Singaporean soars in every field they put their foot into. We can see from this one slide how far ahead is everyone else in terms of Phase 1 studies.
I checked with NMRR, we have two Phase 1 studies in this country as of today.

All in all, I enjoyed the conference very much, it shows me how behind is my exposure to current world and we need super flying speed to be catching up with the rest of the world.

Perhaps we should start with nurturing good research attitude and research culture. 

and pray.

Thanks for reading.

Wednesday, October 21, 2015

Do work for a cause. Not for applause.

Live life to express. Not to impress.

Tuesday, October 13, 2015


Arghhh..still struggling to get the pace to settle the review of CVS.

Actually it is an easy task to do, as in everything is just in the computer, but I have too many distractions.

Need to step up and gear up!

The plan is to settle it within 1 month, get it published, and then move on to other papers I already can write it up.

Come on Ang!

Thursday, August 06, 2015


20% progress....since started in Bukit Fraser

Oh why write-up so slow...why....

Must settle in 2 weeks!!

Come on Ang Choon Seong!


Friday, July 24, 2015


Semua nak menang, siapa nak kalah?

As I ages, I starts to understand the heavy meaning of the above seemingly light sentence

Sunday, July 05, 2015

Bangkok 5565

I went to Bangkok for an investigators meeting.
Konkunkap to this company and this study.

DS - Arigatokap

Hospitality is so superb. (Already buying 5565 for today Magnum/Toto/Kuda)

The Westin Hotel is really a very posh hotel... (yeah, wont be able to afford actually, hahaha..too ex la)

Didnt go anywhere else apart from around the Hotel, coz scared meet orang jahat tangkap. LOL

(lack of travel funds la, "why my father is not Li Kah Sing")

Only went out across the street to the shopping mall, Westin is just right next to one very interesting shopping mall, the Terminal 21.

The concept is based on airport designed terminal...

The 9 storey high Terminal 21
We were treated very nice reception dinner at the 26 storey Altitude with spectacular view of Bangkok. Not a quarter of investigators turned up. For me it shows how investigators treating the investigators meeting concept. Right or wrong? oh well, small potato here I would like to show my gratitude for the hospitality. (oh probably some will cite their disagreement with the profitability of the pharma and their abuses, erm...then why you take the free trip?)

Like this shot.
Would I be one day having a building under my name? ACS on top of the building

DS is a Japanese company. The investigators are trying very hard to converse in English, which is rather difficult to learn for them, as their Japanese Language makes it harder in terms of pronounciation.

So I thought to myself, If I am able to, I will try to learn up this language. 

It will be so cool right, if I blahblahblah in Japanese.

On a serious note, medical advances of the Japanese is very impressive. We must admit that their discipline and attitudes is somewhat very enviable.

We tend to ignore them and continue to idolise the West in terms of medical research. 

But they had too many success stories for us to ignore them actually.

For example, there must be something done very right for their ACS rate to be that low, their rate of transplantation of kidneys are so successful and etc.

Yes, 2017 probably I can - Angchoonseong-san.

Saturday, June 20, 2015


I have always wonder what would I be if I am not a doctor?

"Marketing lah! I can talk to anyone from anywhere of any age one"

"Management lah! I like to organise things and many times to have been able to get people to work hard for me!"

Yes, that might be true.

I applied Medicine because I wanted a reputable line of job.

I want people to know I can do things they cant do, sometimes even with money.

Respect has to be earned.

But as I go further and deeper into medicine, I realised although my deepest interest might not be in medicine, but deep inside us, we have altruistic tendencies.

To see people get well.

To see people happy.

And to see the people we care happy!

That is why I always thought to myself, doctors can only be truly happy, if patients do not pay for their treatments.

When we factor in money, this noble thing that I am trying to do is full of suspicious, full of intent

both from the patients and family,

and myself.

I also want to be rich, who doesnt?

But if money is the one thing that makes you keep going, in this line;

you might not be able to enjoy to be happy anyway.

*Reminder to self, of the real meaning of life, and taking care of lives*