Our journey to raise awareness about NSCLC began with a comprehensive public survey. This survey was designed to assess the existing level of knowledge about NSCLC among the public, identify any prevalent misconceptions, and understand the information gaps that needed to be addressed. This crucial task allowed us to tailor our subsequent educational initiatives to meet the specific needs of the public while also highlighting the urgency of our goal to educate about NSCLC.

A total of 189 respondents participated in the survey, with a demographic spread that provided valuable insight into the understanding of NSCLC across different age groups. Among the respondents, 80.4% were between the ages of 18 and 34, while the remaining 19.6% fell within the 35 to 74 age range.

The survey results revealed an alarming lack of awareness about NSCLC, with 61.4% of respondents reporting no previous knowledge of the disease. Furthermore, when asked about their confidence in their knowledge of NSCLC, only 4.7% expressed confidence, 34.9% admitted to having low confidence, and 44.4% felt completely unconfident. These statistics underscore the pressing need for effective educational initiatives to bridge the information gap.

Regarding treatment options, the survey revealed that 40.7% of the respondents were unsure about the answer. Of those who provided an answer, 18% believed that chemotherapy was the common treatment for early-stage NSCLC, whereas 20.6% of respondents chose targeted therapy as the correct answer. While chemotherapy and targeted therapy are indeed common treatment options, the misconception that chemotherapy can cure NSCLC highlights a lack of understanding about the complex nature of the disease and its management.

In terms of side effects, 2.1% of those surveyed correctly identified fatigue and nausea as common side effects of chemotherapy. However, 27.3% were unaware of the potential side effects of chemotherapy, including hair loss.

The survey's results were insightful. They revealed that while many people had heard of lung cancer, they lacked awareness of its different types, such as NSCLC, and their respective implications. There was a general lack of knowledge about early symptoms, risk factors, and the importance of early detection. Furthermore, the survey revealed that a significant majority of the respondents, approximately 75.7%, relied on the internet as their primary source of health-related information. Recognizing the significant influence of online platforms in shaping public knowledge, we devised a strategy to leverage the power of the internet to educate and raise awareness about NSCLC.

Understanding that a substantial number of individuals turn to the internet for basic health information, we saw the opportunity to reach and educate a wide audience by utilizing platforms such as Instagram, Spotify, and YouTube.

To enhance our outreach and maximize our effectiveness, we forged partnerships with organizations such as the Hong Kong Cancer Fund, the largest cancer support organization in the city. The Hong Kong Cancer Fund is dedicated to providing free information and professional support to individuals living with or affected by cancer. Their overarching vision is to enhance the quality of cancer support in Hong Kong and ensure that no one faces cancer alone. This aligns closely with our objective of combating NSCLC and raising public awareness about the disease.

The representatives highlighted the numerous challenges faced by cancer patients, including not only physical and financial burdens but also psychological ones. They underscored the importance of support in managing the stress and emotional toll of a cancer diagnosis, further amplifying the need for projects such as ours that aim to provide information, support, and avenues for community connection.

Based on the insights gained from the interview, we identified several avenues through which our project can contribute to ongoing efforts against NSCLC.

Awareness and Education: The organization highlighted the need for increased public awareness and education about cancer. Our project can contribute to this by developing and distributing educational materials about NSCLC. This may involve hosting seminars, arranging booths, organizing community talks, and using social media such as Instagram and podcasts to disseminate accurate and up-to-date information about the disease.

Fundraising: The Hong Kong Cancer Fund relies heavily on public donations and fundraising activities to continue to provide its invaluable services. As part of our project, we are launching a T-shirt sales campaign. The proceeds from this campaign will be donated to the Hong Kong Cancer Fund, thereby providing financial support for their activities.

Research Dissemination: The organization expressed interest in learning about the outcomes of research projects related to cancer. Our project can support this by sharing our research findings with the organization through presentations, reports, or informational videos.

Support for Patients and Families: The organization detailed the various ways it supports patients and families, including psychological programs, wellness programs, art therapy, and peer support groups. Our project can help drive these initiatives by volunteering our time, advocating for these services, and connecting individuals with these resources.

Through these partnerships, we were able to access networks of individuals who needed this information the most. The NGO, with their deep community ties and understanding, helped us tailor our educational materials to be culturally sensitive and relevant, ensuring that our message was not only heard but also understood.

Interviews with Prof. Mok Shu-Kam, Tony, Dr. Chan Sum-Yin, Ann, Dr. Li Siu-Ching, and a biotechnology company, Arbele Limited provide deeper reflection for our project. The following content presents the insights we gained from these experts.

Key insight from Professor Mok Shu-Kam’s interview

To understand more information on novel lung cancer drugs and resistance, we interviewed Prof. Mok Shu-Kam. This interview provided valuable insights for our project.

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During the interview with Prof. Mok, we discussed different topics, which are listed below.

Evaluating Novel Drugs for Lung Cancer
Professor Mok emphasized that to evaluate the safety and efficacy of novel drugs for lung cancer, researchers must understand how the drugs work at the mechanistic level and compare them to existing drugs. If the novel drug works in a similar way, researchers can refer to knowledge about the existing drug to anticipate toxicity risks related to that mechanism of action, such as skin toxicity from EGFR inhibition or weight gain from Met inhibition. However, truly novel drugs may require new research on their toxicity profile. The key is to balance the need for innovation and the need to minimize potential harm.

Overcoming Drug Resistance
The inevitable emergence of drug resistance in cancer cells necessitates a comprehensive understanding of the underlying resistance mechanisms and the development of strategies to minimize their occurrence. In the case of bispecific antibodies, it is crucial for researchers to ascertain whether these antibodies possess reduced susceptibility to resistance or possess the capability to counteract existing resistance mechanisms associated with the target of interest.

The Blood-Brain Barrier
Although the limited size of monoclonal antibodies hampers their ability to efficiently penetrate the blood‒brain barrier, other contributing factors, such as p-glycoprotein pumps, also exert an influence. However, it is noteworthy that some patients exhibit positive responses to monoclonal antibodies within the central nervous system. Consequently, researchers are actively exploring potential approaches to surmount the challenges posed by the blood‒brain barrier with the aim of enhancing therapeutic delivery to this critical anatomical region.

Future Directions in Lung Cancer Treatment
Several promising avenues of research are currently being explored in the realm of lung cancer treatment. These include immune checkpoint inhibitors, antibody conjugates, cancer vaccines mRNA technology, CAR-T-cell therapy, and gene editing techniques such as CRISPR. These innovative platforms hold significant potential for application in future lung cancer treatments and offer new avenues for improved patient outcomes.

Advice for Young Researchers
For young researchers, it is essential to work collaboratively within teams and establish partnerships with clinicians to gain a comprehensive understanding of clinical requirements and needs. To effectively translate research findings into tangible products, researchers should strive to acquire both laboratory skills and business acumen. Additionally, it is important to acknowledge the role of luck in scientific discoveries. Success in the field of lung cancer research hinges upon fostering collaboration, possessing multidisciplinary skills, and maintaining a blend of insight, perseverance, and fortuitous opportunities.

The interview connects to our project

During the interview, Prof. Mok provided a comprehensive overview of the advances made in the field of anticancer drugs and presented an in-depth analysis of various drug types. Moreover, Prof. Mok generously shared numerous valuable suggestions for our project that profoundly contributed to its improvement. This interview provided us with invaluable insights that hold great potential for enhancing our project's efficacy. Notably, Prof. Mok emphasized the importance of focusing on the development of a novel bispecific antibody that exhibits reduced susceptibility to resistance mechanisms or possesses the ability to inhibit them entirely. By placing emphasis on resistance mechanisms, we can ensure the continued relevance and effectiveness of our project in overcoming existing challenges related to drug resistance. Finally, the content derived from this interview was transformed into a podcast, which serves as a means to educate the general public about advances in anticancer drug development and the latest research dynamics in this field.

Key insight from Dr. Chan Sum-Yin’s interview

To gather comprehensive information on the diverse array of cancer therapies and the available options for patients, we conducted an interview with Dr. Chan.

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Dr. Chan emphasized that detecting cancer at an early stage remains a major challenge in cancer treatment. Many patients are diagnosed with advanced-stage disease when only palliative care can be offered, indicating a need for screening tools to enable earlier diagnosis. Early detection enables potentially curative treatments.

Targeted therapies and immunotherapies provide effective treatment options for some cancers. However, most patients eventually develop resistance, necessitating research into strategies to overcome resistance mechanisms. This is an important area of study to improve long-term outcomes.

Antibody therapies and bispecific antibodies show potential for enhancing treatment responses and controlling disease progression. However, clinicians need to closely monitor patients for potential toxicity issues given the side effects that are sometimes observed with these treatments. Further research to improve safety and efficacy is ongoing.

Well-designed clinical trials are necessary to rigorously evaluate new treatments but require careful patient selection based on factors such as biological markers and disease stage. Informed consent discussions highlight risks and benefits to ensure ethical recruitment. Clinical trials provide access to promising therapies for patients with limited standard options.

Researchers and clinicians must stay abreast of the latest developments by reading guidelines and literature, attending conferences and discussions with colleagues and mentors. This helps to identify innovative treatment ideas and effective strategies to implement in practice.

In summary, Dr. Chan highlighted that early cancer detection, strategies to overcome resistance, antibody therapies, and ethical clinical trials are crucial areas of focus in cancer research and treatment. Additionally, maintaining up-to-date knowledge through multiple sources is vital for progress.

The interview connects to our project

In this interview, Dr. Chan introduced us to the current clinical trial methods and treatment approaches for lung cancer patients in the hospital. Since our team did not have direct access to lung cancer patients, Dr. Chan served as a bridge between us and the patients, enabling our team to better understand their specific needs. In addition, Dr. Chan pointed out the missing part of our project, the toxicity test. However, due to time limitations, the test may not be completed in a short time. The proactive approach is to recommend that this will be one of our future plans to make our drugs safer. This interview also became part of a podcast episode, allowing the general public to gain a deeper understanding of the challenges and difficulties faced by lung cancer patients as well as the needs and limitations of the medical community.

Key insight from Dr. Li Siu-Ching’s interview

We interviewed Dr. Li to gain valuable insight into clinical trials and the exploration of new therapies, biomarkers, and collaborative efforts aimed at enhancing lung cancer treatment.

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In the interview, Dr. Li shared that information about lung cancer presents major challenges for treatment due to late-stage diagnosis, treatment resistance, and a lack of effective options for advanced cases. Over 50% of patients present with Stage IV cancer that has already spread, limiting treatment options. Even with targeted therapies and immunotherapies, resistance develops, and survival remains poor.

When determining treatment plans, doctors consider patients' fitness, symptoms, preferences, tumor genomic status to identify driver mutations, and PD-L1 expression to determine whether immunotherapy is suitable. The development of targeted therapies for common driver mutations such as EGFR has increased survival to over 3 years and improved quality of life.

Emerging treatments such as antibody conjugates, bispecific antibodies, and immunotherapy combinations show promise in overcoming resistance to current treatments. Although immunotherapy has benefits such as durable responses and lower toxicity, it is not effective for all patients and can cause autoimmune side effects.

Dr. Li also mentioned that clinical trials are crucial for testing and approving new therapies as well as giving patients access to novel treatments that may improve their outcomes. Collaborative research across disciplines is necessary to identify unmet clinical needs and translate scientific discoveries into effective treatments that can make a meaningful difference for lung cancer patients. Overall, a combination of new therapies, biomarkers, and collaborative research efforts holds the greatest potential to finally make major strides in lung cancer treatment and outcomes.

The interview connects to our project

During the interview, Dr. Li extensively discussed the various treatments available for lung cancer as well as the pros and cons of these treatments. NSCLC patients with development of Osimertinib resistance have limited treatment options, so our project aims to solve this problem. Furthermore, the interview was transformed into a podcast to disseminate cancer treatment knowledge to a wider audience, enabling the general public to gain insight into the diverse treatment modalities, their advantages, and their limitations.

Key insight from Arbele Limited’s interview

Arbele Limited is a biotech company focused on developing immunotherapies and diagnostics for gastrointestinal cancers. Notable achievements include establishing R&D hubs in the US and Hong Kong in 2016, developing five to six drug candidates between 2016 and 2020, and receiving awards and grants.

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Their lead drug candidate ARV2 completed phase I studies in 2019 and was the subject of an FDA meeting in 2021. Clinical trials began in 2022 in Australia and will be expanded internationally. Technology platforms include natural killer (NK) cell therapies, bispecific antibodies, and diagnostics. The target patients are advanced gastrointestinal tract cancer patients in Asia, where the incidence is high. The diagnostic platform also targets high-risk colorectal cancer populations in China. R&D occurs in the US, Hong Kong, and Guangzhou, while production occurs in China through CDMOs.

Arbele has an exclusive license for its CAR-T17 target from previous work in Hong Kong. For a bispecific antibody project targeting NSCLC resistance, understanding the eligible patient market size is key.

As a startup, Arbele's highest costs were operational expenses for laboratories, equipment, and hiring staff to conduct R&D and apply for grants. Building a strong team and conducting thorough market research are also important for commercialization.

The interview connects to our project

In this interview, the person in charge of Arbele talked to us about how the company gradually developed from an idea in biotechnology to having subsidiaries worldwide. They also reviewed our business plan and gave us suggestions and insights to improve our business plan. Furthermore, they shared their company's structure and how the company gradually developed to the current scale. This gave us a clearer understanding of how we should proceed with future development. They also let us visit their company's lab, which allowed us to understand the production scale of a large company and the various procedures required during production.

To learn more details about our business plan!

Business Plan

In the digital age, online platforms are powerful tools for spreading information quickly and widely. We leveraged this power by hosting a series of podcast shows focusing on different aspects of NSCLC. Each episode featured experts in the field, such as oncologists, researchers, and survivors, who shared their insights, experiences, and advice. The podcasts served as an accessible, engaging medium for the public to learn about the disease, its prevention, and treatment options.

We also used Instagram Reels to create short, impactful messages about NSCLC. These bite-sized videos helped us convey crucial information in a way that was easily digestible and shareable, thus amplifying our reach. The appeal of these videos to the younger demographic also helped us educate and engage a section of the population that is often challenging to reach through traditional methods.

Go to our iGEM Video Universe Channel to watch the videos

iGEM Video Universe

Finally, we arranged a sharing session and booth inside a university campus throughout June. This allowed us to interact directly with students and answer their queries about NSCLC. We conducted a sharing session for high school students that allowed them to become familiar with the field of synthetic biology, iGEM and our project. The face-to-face interaction facilitated by the booth was critical in addressing misconceptions and providing accurate, clear information to university students.

The mission of the Hong Kong Cancer Fund is heartfelt and inspiring. Their dedication to ensuring that no one faces cancer alone resonates with the objectives of our team. We are not only eager to learn more about patients' situations that the organization supports, but we also aspire to collaborate with the organization through a charitable merchandising initiative.

To contribute to their noble cause, our team organized a charity merchandising event. We established a booth at our university where we showcased and sold T-shirts designed by our team. Our intention extended beyond raising funds; we aimed to raise awareness among our fellow schoolmates about the importance of caring for cancer patients. During the event, we not only sold merchandise but also shared information about iGEM, our project, and the current challenges faced by patients with NSCLC. By doing so, we sought to ignite empathy and understanding within our community. Ultimately, the proceeds from our fundraising efforts will be donated to the Hong Kong Cancer Fund, enabling them to create additional pathways of support for cancer patients.

Through our collaborative efforts and dedication, we aspire to make a meaningful impact in the lives of those affected by cancer. By joining hands with the Hong Kong Cancer Fund, we strive to ensure that no one faces the daunting journey of cancer alone. Together, we can create a compassionate and supportive environment that empowers individuals and brings hope to those in need. It is heartening to see young people like our team taking action to make a positive impact on the world. Keep up the good work, and may our efforts inspire others to do the same.

According to 2020 data from the Department of the Centre for Health Protection in Hong Kong, lung cancer is the most prevalent cancer in Hong Kong. Among all types of lung cancer, approximately 85% of cases are NSCLC. Lung cancer also topped the list of incidence and mortality in 2020. During our research on lung cancer, we observed that there are several treatment options available for NSCLC, such as radiation therapy, chemotherapy, and targeted therapy. However, with regard to the recurrence of NSCLC, the available treatment choices are limited. Consequently, we have undertaken an investigation to help us better understand the reasons behind the scarcity of treatment options for NSCLC recurrence. Our team proposes a new method to address the resistance of traditional treatment.

Supported by the research team of our university, we discovered a significant piece of information: EGFR mutation occurs frequently in NSCLC, and the presence of c-MET leads to resistance to Osimertinib treatment, rendering them ineffective in eliminating tumors.

In fact, there are new targeted therapies to cure EGFR-mutated NSCLC; however, the therapy cost is too high and is not affordable for most patients. Additionally, the government’s medicine subsidy scheme does not cover the expenses of these new medical treatments. Hence, we endeavor to find a feasible approach to combat drug-resistant NSCLC.

The valuable insights and feedback from stakeholders play a crucial role in shaping our project and expanding our impact globally. Their inputs drive our project progress, ranging from project design and implementation to future development. To view our progress thus far, please click the accompanying figure, which highlights our extensive accomplishments.

A dynamic timeline shows an overview of how our engagements with stakeholders influence the planning and design of our project. These engagements have unified our collective efforts in human practices and ensure that Polyneerab makes a robust and responsible impact on our local community across various domains, including social needs, scientific contribution, project implementation, safety, and business. Additionally, they elucidate the practical implementation of Polyneerab's learning process in real-world scenarios.

The figure below shows the stakeholders we consulted: