Optimizing outcomes for patients with metastatic prostate cancer: insights from South East Asia Expert Panel.

AIMS: Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges. METHODS: Based on evidence in the literature and expert interviews, 19 statements were formulated for key challenges in the treatment of men with castration-sensitive and -resistant prostate cancer in clinical practice. A modified Delphi process was used to reach consensus among experts in the panel and develop clinical practice recommendations. RESULTS: The majority of the panel preferred a risk-based stratification and recommended abiraterone or enzalutamide as first-line therapy for symptomatic chemotherapy naïve patients. Abiraterone is preferred over enzalutamide as a first-line treatment in these patients. However, the panel did not support the use of abiraterone in high risk lymph-node positive only (N+M0) or in non-metastatic (N0M0) patients. In select patients, low dose abiraterone with food may be used to optimize clinical outcomes. Androgen receptor gene splice variant status may be a useful guide to therapy. In addition, generic versions of approved therapies may improve access to treatment to a broader patient population. The choice of treatment, as well as sequencing are guided by both patient and disease characteristics, preferences, drug access, cost, and compliance. CONCLUSION: Expert recommendations are key to guidance for the optimal management of mPC. Appropriate choice, timing, and sequence of treatment options can help to tailor therapy to maximize outcomes in men with mPC.

Bioaccumulation of PCDD/Fs in foodstuffs near Bien Hoa and Da Nang airbases: assessment on sources and distribution.

In this survey, food items were collected from vicinities of Bien Hoa and Da Nang airbase and determined for polychloro-dibenzo-dioxins and polychloro-dibenzo-furans (PCDD/Fs) to assess their accumulation, distribution in the local food items, and risk of PCDD/F exposure through consumption of the local foods. Dioxin compounds were determined using isotope dilution method which is slightly modified from US-EPA method 1613B. The dioxin concentration was the highest in fish followed by eggs, chicken, meat (pork and beef), and vegetables. Particularly, in Bien Hoa airbase, the mean concentrations of dioxin on TEQ and lipid basis (except for vegetables) were 26 pg/g for fish, 13 pg/g for eggs, 20 pg/g for chicken, 4.5 pg/g for meat, and 0.34 pg/g fresh wt for vegetables. In Da Nang airbase, the mean levels of dioxin on TEQ and lipid basis were slightly lower, 12.9 pg/g for fish, 8.7 pg/g for eggs, 5.9 pg/g for chicken, 6.7 pg/g for meat, and 0.17 pg/g for vegetables. It has been interesting to observe that free-range chicken expose to higher level of dioxin than caged chicken. In some free-range chicken, the portion of 2,3,7,8-TCDD was relatively high and implying recent exposure to dioxin.

Site-specific bioaccumulation of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/PCDFs) in mothers and their infants living in vicinity of Bien Hoa airbase, Southern Vietnam.

Bien Hoa airbase is located in Dong Nai Province (Southern Vietnam). Several sites within the airbase are highly contaminated by Agent Orange/Dioxin, and thus, they are also commonly named as an Agent Orange/Dioxin hotpot. In the present study, 36 maternal milk samples were collected from primiparas who have lived at least 5 years in four wards, Buu Long, Quang Vinh, Trung Dung and Tan Phong, which are closed to Bien Hoa airbase in order to investigate the level and distribution of Agent Orange/Dioxin exposure in different local communities. The mean concentrations of PCDD/PCDFs in four investigated wards range from 6.4 to 13.6 pgTEQ/g lipid. The highest mean TEQ of PCDD/PCDFs was observed in Buu Long ward (13.6 pgTEQ/g lipid), followed by Tan Phong ward (12.3 pgTEQ/g lipid), and the lowest value was observed in Trung Dung ward (6.4 pgTEQ/g lipid). The mean concentration of 2,3,7,8-TCDD in Buu Long (7.6 pg/g lipid) was approximately 2-6 times higher than those in Tan Phong (3.9 pg/g lipid), Quang Vinh (2.3 pg/g lipid), or Trung Dung (1.2 pg/g lipid). These results imply site-specific exposure to PCDD/PCDFs in different local communities living around Bien Hoa airbase. The mean values of daily intake of dioxin estimated for the breast fed infants living in Buu Long, Quang Vinh, Trung Dung and Tan Phong were about 80, 37.5, 31.7 and 58 pg TEQ/kg bw/day, respectively.

Distribution, accumulation profile, and risk assessment of polybrominated diphenyl ethers in sediment from lake and river systems in Hanoi Metropolitan Area, Vietnam.

Concentrations of seven polybrominated diphenyl ethers (PBDEs) congeners were determined in surface sediments collected from several rivers and lakes in Hanoi, the capital city of Vietnam, to understand the status of background contamination, accumulation pattern, sources, and toxic implications for benthic organisms. Total PBDE concentrations in all sediment samples ranged from 0.03 to 17.5 ng/g dry weight (mean 1.33 ng/g dry wt). The most predominant congeners were BDE-47 and BDE-99, which comprised 30 and 25 % of total PBDE concentrations, respectively. Results from statistical analysis indicated that the potential sources of PBDEs of sediments in Hanoi may come from penta-BDE and octa-BDE mixtures. Risk quotients of PBDEs in sediments were also calculated for a benthic species, ranged from 2.12 × 10-6 - 1.60 × 10-2, and were markedly lower than threshold value for occurrence of any ecotoxicological risk. This study provides some of the most comprehensive data on the occurrence of PBDEs in sediments from lake and river systems in Vietnam.

Effects of hydrostatic pressure on yeasts isolated from deep-sea hydrothermal vents.

Hydrostatic pressure plays a significant role in the distribution of life in the biosphere. Knowledge of deep-sea piezotolerant and (hyper)piezophilic bacteria and archaea diversity has been well documented, along with their specific adaptations to cope with high hydrostatic pressure (HHP). Recent investigations of deep-sea microbial community compositions have shown unexpected micro-eukaryotic communities, mainly dominated by fungi. Molecular methods such as next-generation sequencing have been used for SSU rRNA gene sequencing to reveal fungal taxa. Currently, a difficult but fascinating challenge for marine mycologists is to create deep-sea marine fungus culture collections and assess their ability to cope with pressure. Indeed, although there is no universal genetic marker for piezoresistance, physiological analyses provide concrete relevant data for estimating their adaptations and understanding the role of fungal communities in the abyss. The present study investigated morphological and physiological responses of fungi to HHP using a collection of deep-sea yeasts as a model. The aim was to determine whether deep-sea yeasts were able to tolerate different HHP and if they were metabolically active. Here we report an unexpected taxonomic-based dichotomic response to pressure with piezosensitve ascomycetes and piezotolerant basidiomycetes, and distinct morphological switches triggered by pressure for certain strains.