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Objective: To evaluate the efficacy and safety of apalutamide + androgen deprivation therapy versus androgen deprivation therapy alone in Japanese patients with metastatic castration‐sensitive prostate cancer from the phase 3, randomized, global TITAN study. Methods: Men with metastatic castration‐sensitive prostate cancer randomly (1:1) received 240 mg apalutamide + androgen deprivation therapy or matching placebo + androgen deprivation therapy. The primary efficacy endpoints were radiographic progression‐free survival and overall survival. Secondary efficacy endpoints were time to cytotoxic chemotherapy, pain progression, chronic opioid use, and skeletal‐related events. Safety was also assessed. Results: Of the 1052 patients included in the TITAN study, 51 (4.85%) were Japanese (apalutamide group, n = 28; placebo group, n = 23). In all, 81.8% of patients in the apalutamide and 71.8% in the placebo group did not experience radiographic progression or death, and the hazard ratio for radiographic progression‐free survival favored treatment with apalutamide (hazard ratio 0.712, 95% confidence interval 0.205–2.466; P = 0.59). At 24 months, 85.7% of patients in the apalutamide group and 81.5% in the placebo group were alive, and the hazard ratio for overall survival favored apalutamide (hazard ratio 0.840, 95% confidence interval 0.210–3.361; P = 0.805). In the interim analysis, the median radiographic progression‐free survival and overall survival were not reached in the apalutamide group and time to cytotoxic chemotherapy was delayed following apalutamide treatment. The safety profile of apalutamide in the Japanese subpopulation was comparable with that of the global population, except for skin rash. Conclusions: The results of the present analyses suggest that apalutamide + androgen deprivation therapy in Japanese patients had favorable efficacy compared with androgen deprivation therapy alone, and these findings are comparable to those in the overall population. Apalutamide + androgen deprivation therapy can be considered as one of the therapeutic options for a broad spectrum of metastatic castration‐sensitive prostate cancer regardless of prior treatment and disease extent in Japanese patients. [ABSTRACT FROM AUTHOR]

It is well known that Asia generates and receives large quantities of plastic waste. Through a detailed study of plastic waste generation and trade, the management and treatment of plastic waste in Asia were analyzed from the regional perspective. The amounts of plastic waste in municipal solid waste and in industrial solid waste were estimated to be 79 Mt and 42 Mt, respectively, in Asia. The overall treatment and recycling status in Asia are unsatisfactory. Asia imported 74% of the plastic waste in the world in 2016, and China (mainland) imported the most plastic waste until 2017, with 5.8 to 8.3 Mt. In 2017, about half the plastic waste imported by Asia came from other regions, and after subtracting the exported quantity, 98% of the plastic waste was left in Asia for treatment and disposal. The plastic waste imported by Asia declined about 72% in monetary value in 2018. There is still a large gap between the plastic waste quantity imported to Asia and that exported from Asia. China's ban of plastic waste imports caused import quantities to drop to 52 kt in 2018, simultaneously, exports from the largest exporting countries or regions such as Hong Kong (China), the USA, Japan, and Germany decreased. While Vietnam, Malaysia and some other Asian countries and regions saw significant increases in plastic waste imports from 2016 to 2018. Considering this situation, countries in Asia are starting to strictly limit plastic waste imports from other countries., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)