The objective of this study was to determine the conversion rate of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR) between primary tumors and metastatic lesions in advanced breast cancer. Patients with suspected diagnosis of locally recurrent or metastatic breast cancer, either at first relapse or after successive disease progressions, who had an appropriately preserved sample from a primary tumor and were scheduled for a biopsy of the recurrent lesion, were included. Blinded determinations of receptor status on paired samples were performed by immunohistochemistry and fluorescence in situ hybridization at a central laboratory and compared with those performed locally. Overall, 196 patients were included and 184 patients were considered evaluable. Reasons for non-evaluability included the inability to perform biopsy (n = 4) or biopsy results showing normal tissue (n = 3), benign disease (n = 3) or a second neoplasia (n = 2). Conversion rates determined at local level were higher than those determined centrally (HER2: 16 vs. 3 %, ER: 21 vs. 13 %, PR: 35 vs. 28 %, respectively). There was substantial agreement regarding the expression of HER2 in primary tumors and metastases, and ER at metastases, between local and central laboratories. PR at any site and ER at primary site showed moderate agreement. Oncologists altered their treatment plans in 31 % of patients whose tumor subtype had changed. These results reinforce the recommendation for performing confirmatory biopsies of metastases, not only to avoid misdiagnosis of breast cancer relapse, but also to optimize treatment (clinicaltrials.gov identifier: NCT01377363).

In CYP2D6 PM patients, increasing the standard tamoxifen dose two-fold or three-fold raises endoxifen concentrations to levels similar to those of patients with EM phenotype.

In the Integrated Coastal Zone Management frame, environmental zoning is considered a tool for land planning and management. It is based on definition and integration of biophysical, socioeconomic and governability criteria. With the aim for using this tool as part of the coastal zone environmental planning in the Atlántico province (Colombian Caribbean) the following criteria were defined: representative level, stage of ecosystem intervention, ecosystem function, current state of associated fauna, natural risks, water balance alteration, land use intensity, land use aptitude and land use conflicts. The integral analysis of criteria allowed the definition of management areas such as strategic ecosystems, recovery zones, sustainable use, sustainable production and urban-suburban areas. These areas were the base for further definition of integrated coastal zone management guidelines. The definition and integral analysis of zoning criteria were based on participatory techniques, interdisciplinary technical workshops and local community participatory process. As well, Geographic Information System supported the spatial analysis criteria over ecological landscape units. The environmental zoning is a tool for environmental planning which requires definition and integration of biophysical, socioeconomic and governability criteria for facing the conflicts and problems found in the area in order to lead management actions. It is hoped that future work will study the incorporation of models to support the selection and qualification criteria in a quantitative way; also it is expected that participatory processes will involve different sectors such as the economic, since they have less participation in these planning processes.

No abstract

In Colombia, Integrated Coastal Zone Management (ICZM) has been implemented through the “National Environmental Policy of the Oceanic Spaces and Coastal and Insular Areas of Colombia-PNAOCI” (Acronyms in Spanish), whose guidelines have considered the need to include marine and coastal ecosystems in land use planning. ICZM, as a special planning approach, can contribute to territorial land use planning of the municipalities located in coastal areas, because it can provide guidelines for the conservation and use of ecosystems in these areas. In this work, the Colombian Pacific coastal area municipalities, which are part of the “Tropical Eastern Pacific Region” and are located between the 01°30´ and the 07°10´ latitude North and between the 77°40´ and the 82°00´ longitude West were taken as a study case. The review of their territorial land use plans was made for each one of the municipalities by means of the descriptive analysis of the biophysical, socio-economical and institutional components, seeking to explain, through the different criteria and particular and critical parameters of the coastal-marine areas, the aspects these municipalities must consider and adjust in their territorial land use planning. The criteria selected are related with aspects such as: existence of the territorial land use plan, demarcation of the coastal area, diagnosis (those aspects such as the identification of strategic marine and coastal ecosystems, high impact natural phenomenon i.e. Tsunamis, coastal erosion, oceanographic process, uses, conflicts, risk and governability aspects), zoning and prospecting. The analysis concludes that the ICZM´s principles incorporated to the territorial land use planning processes in the Colombian Pacific could be the opportunity to minimize impacts from land to sea, and generate space