Exclusive Interview with Dr Manson Fok

Right Team Key to Biomedical Sector Success, Says Expert



Information technology is growing rapidly in China, but it is seen as a herculean task for China to catch up with what is already being done in the United States. “The next major economic driver will be in medicine and biomedical technology. And that’s why China is investing heavily in it,” says surgeon and biomedical technology entrepreneur Dr Manson Fok.

The adjunct professor in the Department of Applied Biology and Chemical Technology at The Hong Kong Polytechnic University is also director of Athenex Inc, a company that listed in Nasdaq in New York last June, and which currently has a market capitalisation of close to US$1 billion.

The firm describes its mission as “the discovery, development and commercialisation of novel therapies for the treatment of cancer”.

Dr Fok says the company is approximately 60 percent owned by Hong Kong investors. He is also chairman of a Hong Kong biomedical firm, Avalon BioMedical Management Ltd.

“Cancer can be like a chronic disease: like AIDS [acquired immune deficiency syndrome], which is not a deadly disease any more,” stated Dr Fok in an interview with Innovation Hong Kong.

“You will be able to take a pill every day to control it. There’s a lot of talk about a cure for cancer. There’s none. There’s no cure for AIDS, but now it’s a chronic condition, not a life-threatening one. It’s the same with hypertension and diabetes: there’s no cure. But they are now controlled by oral medication,” he added.

Hong Kong had until recently “never filed” an Investigational New Drug notice on small-molecule drugs with the United States’ Food and Drug Administration, stated Dr Fok.

“Last year our team, in collaboration with the Hong Kong Polytechnic University, filed the first, the second; and this year we will file the third,” he explained.




Oral drug


Currently Dr Fok and his collaborators are working on a number of orally-administered anti-cancer drugs.

“They convert key front-line cancer drugs to oral, absorbable ones. That may not seem very remarkable, but actually it can be a game changer for cancer treatment,” the specialist said.

“Intravenous chemotherapy is very toxic and makes the patient very sick, and after a while the patient cannot tolerate it, and there are a lot of side effects.”

He added: “Normally the [chemotherapy] drugs are not absorbed through the gut, because for some of these molecules like paclitaxel or irinotecan, there’s a P-glycoprotein pump in the gut wall that pumps these away, once the presence of a toxin is identified.

“Some chemotherapy drugs like paclitaxel only act on the tumour cells when they split from one to two cells – that short time period when the cancer cells are susceptible to drugs like paclitaxel. But of the billions of cells, they don’t divide at the same time; they divide over a period of time. So the chemo only works for that time when effective concentration of the drug is around, which is a fraction of the time in between the dosing of the drugs,” explained Dr Fok.

“Because it’s so toxic, you have to wait for some time before another shot. That’s why it doesn’t work as well as it might. But if you can take it orally, you can do so in a more moderate dose in terms of the achieved plasma level; you can take it over several days, and the tumour is exposed to a longer period of effective dose presence, which should lead to better efficacy,” explained the surgeon.

“We are currently testing four chemotherapy drugs on this technology which leads to oral treatment regimes.”

One is already in phase three clinical trials across the world including in South and Central America; the U.S., New Zealand; and Taiwan.

“In metastatic breast cancer patients, we found in preliminary studies good response rates. And the good thing is, most of these patients don’t have some of the important side effects – including painful neuropathy – common in patients receiving the conventional infusion of paclitaxel,” Dr Fok noted.


Patient dignity


“The patients go on with their lives, and none of the patients have had to go into hospital initially, and most have been able stay away from hospitals. The drug is taken at home… We feel it also brings dignity back to cancer patients,” he said.

“As a cancer surgeon I deal with oesophageal cancer. But I can only help one patient at a time: there’s a limit to what I can do. But if our team can develop a drug, and really deliver on what we believe can be achieved it will be a game changer for a lot of advanced-stage cancer patients that would otherwise not benefit from conventional therapies such as surgery and intravenous chemotherapies.  If it makes their lives better… that is a reward in itself,” noted Dr Fok.

“A few years go when our team started, we approached many potential investors in Hong Kong, and it was very difficult at the beginning, because you don’t have anything to tell them or to show, and they thought the [investment] risk was too high,” he stated.

“Now the situation is reversed… Because we started some of the work here, we got people in Hong Kong interested and investing, and some of these investors are influential, including Ma Huateng,” said Dr Fok, referring to the Chinese entrepreneur and philanthropist who founded information technology-based conglomerate Tencent Holdings Ltd.

“We have got people noticing, and the government is also supporting our initiatives,” stated Dr Fok.

“As long as you design it professionally and execute the plan well, you don’t need to spend billions of U.S. dollars to build that product. Our execution and results have been positive, and the FDA has agreed with our approach in clinical study design. If successful, our approach also has the potential of saving medical costs associated with hospitalisation and from the treatment of related complications,” he added.

Dr Fok additionally noted there was a need to optimise the pursuit of biotechnology.

“Often when people want to create something [in this sector] the first thing they do is build laboratories and buy a lot of very expensive equipment.

That may not be the best way to execute biotechnology projects. In Hong Kong and other developed jurisdictions, there is lot of good equipment available in universities that we can use with the agreement of those universities.”

Dr Fok asserted: “It’s more about how to collaborate and put the good and right people together, because biotech is not about money, it’s not about the machines, it’s about the talents and the experience of the participants. You must assemble an A-team of specialists who know what they are doing, to be able to produce an A-class product.”

























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