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Objective: To describe how the Asian National Cancer Centers Alliance (ANCCA) members preserve high standards of care for cancer patients while battling the COVID-19 pandemic and to propose new strategies in the Asian Cancer Centers’ preparedness to future pandemics. Methods: A 41-question-based survey was developed using an online survey tool and conducted among 15 major Asian National Cancer Centers, including 13 ANCCA members. Direct interviews of several specialists were conducted subsequently to obtain additional answers to key questions that emerged during the survey analysis. Result: Institution/country-specific results provided a strong insight on the diverse ways of managing the pandemic around Asia, while maintaining well-balanced cancer care. Pragmatic strategies were put in place in each NCC hospital, including zoning and intensive triage depending on the pandemic impact. Distancing strategies and telemedicine were implemented in different capacity depending on the national healthcare system. In addition, there was a diverse impact on the manpower and financial aspect of cancer care across surveyed NCCs relating to magnitude of the pandemic impact on the country. Conclusion: The priorities nevertheless remain on maintaining cancer care delivery while protecting both patients and health care workers from the risk of COVID-19 infection. The role of a think-tank such as ANCCA to help share experiences in a timely manner can enhance preparedness in future pandemic scenarios.

The socioeconomic burden of cancer is growing rapidly in the Asian region, with a concentrated burden on low- and middle- income countries. The residents of this region, representing almost 60% of the global population, demonstrate an eclectic and complex nature, with huge disparities in ethnicity, sociocultural practices among others. The Asian National Cancer Centers Alliance (ANCCA) was established in 2005 by heads of several national cancer centers (NCCs) in the region to address common issues and concerns among Asian countries. During the first 13 years of ANCCA’s existence, the participating NCCs’ senior managers paved the way toward collaboration through transparent sharing of key facts and activities. Concrete achievements of the Alliance include the Asia Tobacco-Free Declaration, the establishment of the ANCCA Constitution in 2014 as well as the creation of an official website more recently. In November 2019, the most active ANCCA members (China, India, Indonesia, Japan, Korea, Mongolia, Singapore, Thailand, and Vietnam) strengthened the bonds of the entity with the clear aim to halt the increase in cancer and mortality rates in Asian countries by 2030. New opportunities including accelerated cooperation between members as well as collaboration with external and multidisciplinary stakeholders at local, regional and international levels are an essential step to most effectively tackle cancers in Asia.

The degradation of Pt-based catalysts is considered as the main barrier to the commercialization of fuel cells. M-doped TiO2 (M is a transition metal) has been investigated to improve the stability of electrocatalysts. Recently, W-doped TiO2 materials have been found as a good catalyst support for the photocatalyst applications but their application in Proton-exchange membrane fuel cell application has rarely been reported. In addition, the agglomeration of nanoparticles, which are synthesized from the organic precursor, has been reported. Here, we report Ti0.7W0.3O2 nanoparticles prepared via a one-step solvothermal method with inorganic precursors without using surfactants or stabilizers for restricting nanoparticle agglomeration. The properties of the material were measured by XRD, TEM, BET, and electronic conductivity. The mean particle size of ∼5 nm, the high specific surface area of 126.471 m2/g and a moderate electronic conductivity of 0.014 S/cm were obtained for the sample prepared at 220 °C for 4 h. It was observed that using inorganic precursors to prevent particle agglomeration is more advantageous compared to organic precursors as mentioned in previous reports.

Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health, major public hospitals, and medical universities. An empirical analysis of palliative care need by the Ministry of Health in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations. As advanced and specialist training programs in palliative care became available, graduates of these programs began helping to establish palliative care services in their hospitals. However, community-based palliative care is not covered by government health insurance and thus is almost completely unavailable. Work is underway to test the hypothesis that insurance coverage of palliative home care not only can improve patient outcomes but also provide financial risk protection for patients' families and reduce costs for the health care system by decreasing hospital admissions near the end of life. A national palliative care policy and strategic plan are needed to maintain progress toward universally accessible cost-effective palliative care services.

We report the facial synthesis of BiVO4crystals with different morphologies by the solvothermal and hydrothermal process. The phase structure and morphology as-synthesized samples were characterized by XRD, FE-SEM, and UV-vis DRS spectroscopy. We also investigated the photocatalytic activity of BiVO4for the decomposition of rhodamine B (RhB) under visible light irradiation. The results showed that oliver-like BiVO4was obtained when using the mixed solvent of ethylene glycol and water while starflower-like BiVO4was obtained using the mixed solvent of ethylene glycol monomethyl ether and water. The hydrothermal evolution process the BiVO4product with a rod-like morphology. Oliver-like BiVO4with pure monoclinic scheelite phase and high specific surface area exhibits efficient photodegradation of RhB (k = 7.82x10-3min-1).

This study aims at optimizing the adsorption of heavy metal ions onto banana peel derived activated carbon (AC) using response surface methodology (RSM) involving central composite design (CCD). The cheap, non-toxic and locally available banana peel was subjected to carbonization and subsequently KOH-activation to produce the porous AC, which was then characterized by SEM and FTIR analyses. In RSM study, the individual and interactive effects of three critical variables including heavy metal ion concentration, pH of solution and AC dosage on the adsorption capacity were optimized. The maximum adsorption capacity appeared to follow the order: Cu2+ (14.3 mg/g)

Introduction: Results of laparoscopic colectomies from developing nations are reported rarely. We report our results of laparoscopic abdominoperineal resec-tion (LAPR) for low rectal cancer at K Hospital (National Cancer Hospital of Vietnam). Materials & Methods: From January 2012 to December 2015, a to-tal of 135 patients who were diagnosed with low rectal adenocarcinoma were recruited to evaluate for LAPR surgical outcome performed at the K Hospital in Vietnam. The goal of the study was to compare post-surgical data from K Hos-pital with Western countries. Data were collected including age, gender, history of previous abdominal surgery, operative time, estimated blood loss (EBL), conversion rate, number of harvested lymph nodes, complications, time to re-turn of bowel function (TRBF), length of stay (LOS), TNM staging and overall survival. Results: There were 69 male and 66 female patients. The mean age at diagnosis was 55.3 years (range 29 - 68 years). 19 patients had previous ab-dominal surgeries. One patient had a conversion to open LAPR due to ureteral and bladder injury. The mean and standard deviation for number of harvested lymph nodes was 14.6 ± 5.3; mean operative time 133 ± 20.9 minutes and mean EBL 13.6 ± 12.2 ml. There were two cases of urinary retention that required bladder catheterization for more than 48 hours. There was no perioperative mortality. The TRBF was 33 ± 4.4 hours. Mean LOS was 7.4 ± 1.8 days. 98 patients (72.6%) had stage II and 37 patients (27.4%) had stage III disease. The overall 1-year, 2-year and 3-year survival was 95.8%, 82.1% and 73.3%, respectively. Conclusion: LAPR for low rectal cancer in K hospital is feasible and safe.

Accurate public perceptions on the risk factors associated with cancer are important in promoting primary, secondary, and tertiary prevention. Limited studies have explored this topic among patients with cancer in non-western, low-to-middle-income countries. A cross-sectional survey to compare Australian and Vietnamese cancer patients’ perceptions of what caused their cancer was undertaken. Adult, patients with cancer from both countries, receiving radiotherapy treatment completed a standardized survey, which included a 25-item module assessing their beliefs on the causes of their cancer. Items ranged from known evidence-based causes (eg, smoking, sun exposure) to non-evidence-based beliefs (eg, stress or anxiety, physical injury, or trauma). Country-specific logistic regression analyses were conducted to identify differences in the determinants of patients’ top perceived causes. A total of 585 patient surveys were completed (75% response rate; 285 from Australia, and 300 from Vietnam). Most patients were male (58%) and aged 60 years and older (55%). The most frequently reported risk factor overall and for the Australian sample was “getting older” (overall = 42%, Australia = 49%, and Vietnam = 35%). While the most frequently reported risk factor for the Vietnamese sample was “poor diet” (overall = 39%, Australia = 11%, and Vietnam = 64%). There were differences in the characteristics associated with the top causes of cancer identified by Australian and Vietnamese patients. Patients’ beliefs about what may have caused their cancer are complex and likely to be impacted by multiple factors, including the country from which they reside. Developing public awareness campaigns that are accurate and tailored to address the specific beliefs and possible misconceptions held by the target community are needed. Refereed/Peer-reviewed

Recently, the graphite based materials have gained interest as excellent platforms to remove aqueous pollutants via adsorption routes. This is given that such materials possess large specific surface area and low density. In the present work, a comparative study of two facile and effective approaches is conventional thermal heating and microwave irradiation methods to fabricate expanded graphite from available flake graphite sources of Vietnam for oil-contaminated water purification. The as-prepared expanded graphite was characterized by using FT-IR, SEM, XRD and BET analysis. The results exhibited that expanded graphite has multilevel pore structures and the surface area of expanded graphite obtained from microwave irradiation and conventional heating was 147.5 (m²/g) and 100.97 (m²/g) under optimal processing conditions. The as-synthesized expanded graphite from the microwave irradiation method was found to have higher adsorption capacities for diesel oil, crude oil, and fuel oil compared to conventional heating method.

Purpose The global burden of cancer is slated to reach 21.4 million new cases in 2030 alone, and the majority of those cases occur in under-resourced settings. Formidable changes to health care delivery systems must occur to meet this demand. Although significant policy advances have been made and documented at the international level, less is known about the efforts to create national systems to combat cancer in such settings. Methods With case reports and data from authors who are clinicians and policymakers in three financially constrained countries in different regions of the world—Guatemala, Rwanda, and Vietnam, we examined cancer care programs to identify principles that lead to robust care delivery platforms as well as challenges faced in each setting. Results The findings demonstrate that successful programs derive from equitably constructed and durable interventions focused on advancement of local clinical capacity and the prioritization of geographic and financial accessibility. In addition, a committed local response to the increasing cancer burden facilitates engagement of partners who become vital catalysts for launching treatment cascades. Also, clinical education in each setting was buttressed by international expertise, which aided both professional development and retention of staff. Conclusion All three countries demonstrate that excellent cancer care can and should be provided to all, including those who are impoverished or marginalized, without acceptance of a double standard. In this article, we call on governments and program leaders to report on successes and challenges in their own settings to allow for informed progression toward the 2025 global policy goals.

The degradation of Pt-based catalysts is considered as the main barrier to the commercialization of fuel cells. M-doped TiO2 (M is a transition metal) has been investigated to improve the stability of electrocatalysts. Recently, W-doped TiO2 materials have been found as a good catalyst support for the photocatalyst applications but their application in Proton-exchange membrane fuel cell application has rarely been reported. In addition, the agglomeration of nanoparticles, which are synthesized from the organic precursor, has been reported. Here, we report Ti0.7W0.3O2 nanoparticles prepared via a one-step solvothermal method with inorganic precursors without using surfactants or stabilizers for restricting nanoparticle agglomeration. The properties of the material were measured by XRD, TEM, BET, and electronic conductivity. The mean particle size of ∼5 nm, the high specific surface area of 126.471 m2/g and a moderate electronic conductivity of 0.014 S/cm were obtained for the sample prepared at 220 °C for 4 h. It was observed that using inorganic precursors to prevent particle agglomeration is more advantageous compared to organic precursors as mentioned in previous reports.

To determine the nutritional status of patients with esophageal cancer, and to investigate its relationship with performance status and prognosis.This clinical, cross-sectional study was conducted from August 2014 to February 2015 at National Cancer Hospital, Hanoi, Vietnam. Stage III/IV esophageal cancer patients were assessed for their nutritional status (patient-generated subjective global assessment (PG-SGA) and SGA scores, BMI, mid-arm circumference (MAC), energy and protein intakes, weight changes, Karnofsky and Eastern cooperative oncology group performance scores (KPS/ECOG), and Glasgow prognostic score (GPS).Sixty-four male patients were enrolled. The mean ± standard deviation of PG-SGA score was 9.88±4.41. SGA revealed 44% as class B and 6.2% as class C. The BMI revealed 43.8% of patients were underweight. MAC measurement revealed 29.7% of undernourished patients. Patients with an energy intake25 kcal/kg/d comprised 54.7%, and 48.4% with1 g/kg/day of protein. Totally, 68.8%, 84.4% and 92.2% patients exhibited weight loss past 2-weeks, one-month and six-months, respectively. The PG-SGA and SGA strongly correlated with the KPS (r=-0.717 and 0.632, both p0.001) and ECOG (r=0.672 and 0.626, both p0.001), but were weakly correlated with the GPS (r=0.332 and 0.278, p0.01 and 0.05). The KPS, ECOG, BMI, MAC, energy and protein intakes, and weight change were not correlated with the GPS.Malnutrition, weight change, and insufficient intake were noteworthy in esophageal cancer patients. The PG-SGA and SGA were strongly correlated with the performance status, but weakly correlated with prognostic indices.

Aim To assess the safety and tolerability of adjuvant subcutaneous trastuzumab (Herceptin ® SC, H SC), delivered from an H SC Vial via hand-held syringe (Cohort A) or single-use injection device (Cohort B), with or without chemotherapy, for human epidermal growth factor receptor 2 (HER2)-positive stage I to IIIC early breast cancer (EBC) in the phase III SafeHer study (NCT01566721). Methods Patients received 600 mg fixed-dose H SC every 3 weeks for 18 cycles. The chemotherapy partner was at the investigators' discretion (H SC monotherapy was limited to ≤10% of the population). Data from the first H SC dose until 28 days (plus a 5-day window) after the last dose are presented. Results are descriptive. Results In the overall population, 2282/2573 patients (88.7%) experienced adverse events (AEs). Of the above, 128 (5.0%) patients experienced AEs leading to study drug discontinuation; 596 (23.2%) experienced grade ≥ 3 AEs and 326 (12.7%) experienced serious AEs. Grade ≥ 3 cardiac disorders were reported in 24 patients (0.9%), including congestive heart failure in eight (0.3%). As expected, the AE rates varied according to the timing of chemotherapy in both cohorts, with higher rates in concurrent versus sequential chemotherapy subgroups. In the concurrent chemotherapy subgroup, AEs were more common during the actual period of concurrent chemotherapy compared with the period when patients did not receive concurrent chemotherapy. Conclusion SafeHer confirms the safety and tolerability of the H SC 600 mg fixed dose for 1 year (every 3 weeks for 18 cycles) as adjuvant therapy with concurrent or sequential chemotherapy for HER2-positive EBC. These primary analysis results are consistent with the known safety profile for intravenous H and H SC.

Background : The Asia-Pacific Breast Initiatives (APBI) I and II registries were established to collect safety data for patients with early stage breast cancer receiving adjuvant docetaxel-based regimens in the Asia-Pacific region. Materials and Methods: Data from the two registries were combined to perform a safety analysis. Participants in the registry were women with early stage operable breast cancer with an intermediate or high risk of recurrence. These women received adjuvant chemotherapy that included docetaxel between 2006 and 2011. Adverse events (AEs) were recorded and analyzed. Results: Data were collected from 3,224 patients from 13 countries. The mean dose intensity of docetaxel was 24.1, 22.7, 25.1 mg/m 2 /week among patients receiving docetaxel-based monotherapy, combination therapy and sequential therapy, respectively. Granulocyte colony-stimulating factor (G-CSF) was given with docetaxel to 41.8% of women and 20.6% of women receiving prophylactic antibiotics. Adverse events were reported in 86% of patients (anthracycline-containing regimens vs. non-anthracycline regimens; 87% vs. 80%). The most common adverse events were alopecia, nausea, neutropenia, vomiting, and myalgia. Adverse events NCI CTCAE ≥Grade 3 were reported in 45.4% of patients. Serious adverse events were reported in 13% of patients, of which 2.5% led to study discontinuation. Forty-six deaths (1.4%) were reported, with no significant difference between regimens. Conclusions: The safety parameters of adjuvant docetaxel therapy used to treat sequential Asian women were comparable to those reported in clinical trials evaluating the role of adjuvant docetaxel. No unusual adverse events linked to Asia-Pacific region patients were observed. Keywords: Adjuvant therapy - docetaxel - early breast cancer - taxanes

This study aimed at preparing low cost activated carbon (AC) from sugarcane bagasse by ZnCl2 activation and evaluating the effects of synthesis conditions and variables using the response surface methodology (RSM) approach for the adsorption of Cu (II) ion from aqueous solution by the synthesized ACs. From the analysis of variance (ANOVA), the most influential factors including activation temperature, impregnation ratio and activation time on each experimental design response were investigated. The optimized conditions for preparation of AC and removal of Cu (II) ions were identified with the activation temperature of 673 K, impregnation ratio of 1.5 and activation time of 35.2 minutes. An optimized conditions based–test experiment with 48.8 % of AC yield and 92.3 % Cu (II) ion removal was observed.

Background The Asia Pacific Breast Initiatives (APBI) I and II were set up to capture data for patients with early-stage breast cancer receiving docetaxel-based regimens in adjuvant chemotherapy. Data from the two registries were combined for an interim safety analysis. Methods We analysed pooled data from the APBI registries, which included patients newly diagnosed with early-stage operable breast cancer with a high risk of recurrence who were receiving a range of docetaxel-based adjuvant chemotherapy regiments during 2006–2011, from 13 countries. Adverse events (AEs), serious adverse events (SAEs), and deaths were categorised and analysed to assess the comparative safety of the anthracycline and non-anthracycline groups. Findings The safety analysis was done in 3224 datasets. The therapy-wise classification of patients is shown in the table. The mean dose intensity of docetaxel was 24.1, 22.7, and 25.1 mg/m 2 per week in patients receiving docetaxel-based monotherapy, combination, and sequential therapy, respectively. Of the chemotherapy support drugs administered, 35.60% and 19.67% of the overall population received growth factor support (granulocyte colony-stimulating factor, G-CSF) and antibiotics, respectively. Exploratory analysis revealed that the proportion of patients receiving G-CSF was numerically higher in the combination arm (62.5%) compared with the arm receiving sequential therapy (25.9%) with docetaxel; antibiotics were given to 20.5% and 21.5% of patients in these categories, respectively. AEs of grade 3 or worse were reported in 45.4% of patients. AEs related to chemotherapy were reported in 45.4% and 37.6% of patients receiving anthracycline and non-anthracycline chemotherapy, respectively. The most common AEs in the two groups were alopecia (57.8% of patients on anthracyclines versus 49.3% of those on non-anthracycline regimens), nausea (58.2% versus 30.2%), decreased neutrophils (45.3% versus 29.4%), vomiting (43.3% versus 14.2%), and diarrhoea (24.1% versus 23.5%). SAEs were reported in 13% of the overall population. Overall, 46 deaths (1.4%) were reported, of which 41 were in the anthracycline group and five were in the non-anthracycline group. Interpretation The combined analysis of results shows that the safety profiles of anthracycline-based and non anthracycline-based chemotherapy regimens are comparable. Concurrent use of docetaxel appeared to require more G-CSF support than sequential therapy.

Cervical cancer remains one of the leading causes of cancers in women from Indonesia, Malaysia, the Philippines, Thailand and Vietnam. High-risk human papillomavirus (HPV) types, particularly HPV-16 and 18, are consistently identified in cervical cancer cases regardless of geographical region. Factors that have been identified to increase the likelihood of HPV exposure or subsequent development of cervical cancer include young age at first intercourse, high parity and multiple sexual partners. Cervical cancer screening programs in these countries include Pap smears, single visit approach utilizing visual inspection with acetic acid followed by cryotherapy, as well as screening with colposcopy. Uptake of screening remains low in all regions and is further compounded by the lack of basic knowledge women have regarding screening as an opportunity for the prevention of cervical cancer. Prophylactic HPV vaccination with the quadrivalent vaccine has already been approved for use in Malaysia, the Philippines and Thailand, while the bivalent vaccine has also been approved in the Philippines. However, there has been no national or government vaccination policy implemented in any of these countries.

Purpose The goal of this registry was to collect patient characteristics and safety data from patients from the Asia-Pacific region with early breast cancer receiving adjuvant chemotherapy containing docetaxel (Taxotere®). Methods This registry was open-label, international, longitudinal, multicenter, and observational in design and included a prospective group of consecutive early breast cancer patients with an intermediate-to-high risk of recurrence being treated with various docetaxel-based (anthracycline and non-anthracycline) adjuvant chemotherapy regimens during 2009-2013 in real-world clinical settings. Results The analysis included 1,712 patients, 79% of whom received docetaxel-based, anthracycline-containing regimens, while 21% received non-anthracycline-containing regimens. Patients receiving adjuvant docetaxel-based chemotherapy were followed for 1.5 years. Chemotherapy-related adverse events (AEs) were reported by 76.2% of patients (anthracycline-containing vs. non-anthracycline-containing regimens: 76.8% vs. 74.1%). Serious AEs were reported in 12% of patients (12.3% vs. 10%). National Cancer Institute Common Terminology Criteria for Adverse Events grade 3 or higher neutropenia was reported in 20% of patients (21.6% vs. 13.9%), leukopenia in 7.4% of patients (5.4% vs. 14.8%), and vomiting in 1.6% of patients (1.8% vs. 0.6%). Treatment-related death was reported in 27 patients (1.6%), while only 3% of patients had a relapse. Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (HDL-C) and total cholesterol/HDL-C ratios increased after chemotherapy. A clinically insignificant reduction of 1.9% in left ventricular ejection fraction, from 66.43 to 64.53, was observed 1.5 years after therapy was completed. Conclusion The Asia-Pacific Breast initiative II registry identified a variety of important facts regarding patient population characteristics, disease epidemiology and treatment response for early breast cancer patients of the Asia-Pacific region receiving docetaxel-based chemotherapy. Docetaxel-based chemotherapy did not show any significant safety concerns for early breast cancer patients of the Asia-Pacific region, and thus may represent a safe adjuvant chemotherapy regimen for these patients.

PURPOSE: In 1992, the Early Breast Cancer Trialists’ Collaborative Group reported that a meta-analysis of six randomized trials in European and North American women begun from 1948 to 1972 demonstrated disease-free and overall survival benefit from adjuvant ovarian ablation. Approximately 350,000 new cases of breast cancer are diagnosed annually in premenopausal Asian women who have lower levels of estrogen than western women. PATIENTS AND METHODS: From 1993 to 1999, we recruited 709 premenopausal women with operable breast cancer (652 from Vietnam, 47 from China) to a randomized clinical trial of adjuvant oophorectomy and tamoxifen (20 mg orally every day) for 5 years or observation and this combined hormonal treatment on recurrence. At later dates estrogen- and progesterone-receptor protein assays by immunohistochemistry were performed for 470 of the cases (66%). RESULTS: Treatment arms were well balanced. With a median follow-up of 3.6 years, there have been 84 events and 69 deaths in the adjuvant treatment group and 127 events and 91 deaths in the observation group, with 5-year disease-free survival rates of 75% and 58% (P = .0003 unadjusted; P = .0075 adjusted), and overall survival rates of 78% and 70% (P = .041 unadjusted) for the adjuvant and observation groups, respectively. Only patients with hormone receptor–positive tumors benefited from the adjuvant treatment. In Vietnam, for women unselected for hormone receptor status, a cost-effectiveness analysis suggests that this intervention costs $350 per year of life saved. CONCLUSION: Vietnamese and Chinese women with hormone receptor–positive operable breast cancer benefit from adjuvant treatment with surgical oophorectomy and tamoxifen.