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Background and Aims: In patients with Rat sarcoma proto-oncogene (RAS) wild-type metastatic colorectal cancer (mCRC), anti-epidermal growth factor receptor (EGFR) antibodies have been established in first- and further therapy lines. Due to limited treatment options upon disease progression, anti-EGFR re-exposure is increasingly employed in real-world oncology. The aim of this study was to assess clinical implementation and utility of anti-EGFR retreatment strategies in real-world mCRC patients. Methods: In this monocentric retrospective study, we included 524 patients with CRC and identified patients who received an anti-EGFR-based treatment as well as anti-EGFR rechallenge (progression on first-line anti-EGFR therapy) or reintroduction (discontinuation due to intolerance/toxicity/other). Results: In total, 143 patients received an anti-EGFR-based first- or second-line treatment, showing a similar overall survival (OS) compared to the non-anti-EGFR treatment group (38.3 vs. 39.6 months, p = 0.88). Thirty-three patients met the inclusion criteria for anti-EGFR re-exposure and were either assigned to rechallenge (n = 21) or reintroduction (n = 12) subgroups. The median FU after re-exposure was 45.8 months. Cetuximab and Panitumumab were used in 21 and 12 patients, respectively, and the main chemotherapy at re-exposure was FOLFIRI in 39.4%. Anti-EGFR re-exposure was associated with a distinct trend towards a better outcome (median OS 56.0 vs. 35.4 months, p = 0.06). In a subgroup comparison, reintroduction was associated with a higher OS and PFS in trend compared to the rechallenge (mOS 66 vs. 52.4, n.s., mPFS 7.33 vs. 3.68 months, n.s.). Conclusions: This retrospective study provides real-world evidence underscoring that anti-EGFR re-exposure strategies might benefit patients independently of the reason for prior discontinuation.
Active species reintroduction is an important conservation tool when aiming for the restoration of biological communities and ecosystems. The effective monitoring of reintroduction success is a crucial factor in this process. Here, we used a combination of environmental DNA (eDNA) techniques and species distribution models (SDMs) to evaluate the success of recent reintroductions of the freshwater fish Alburnoides bipunctatus in central Germany. We built SDMs without and with eDNA presence data to locate further suitable reintroduction sites and potentially overlooked populations of the species. We successfully detected eDNA of A. bipunctatus at all reintroduction sites, as well as several adjacent sites mostly in downstream direction, which supports the success of reintroduction efforts. eDNA‐based species detection considerably improved SDMs for A. bipunctatus, which allowed to identify species presence in previously unknown localities. Our results confirm the usefulness of eDNA techniques as standard tool to monitor reintroduced fish populations. We propose that combining eDNA with SDMs is a highly effective approach for long‐term monitoring of reintroduction success in aquatic species.
At the edge of the Harz Mountains in Lower Saxony a population of the hart's tongue fern (Asplenium scolopendrium) threatened by destruction by a gypsum quarry were transplanted into a dolina which was not populated by the species at that time, and the new population was followed over ten years. 90% of the 59 transplanted plants survived this period and grew larger during the first six years after transplantation. Progenies appeared in the third year after transplantation. Nowadays, in the tenth year after transplantation, there are 1110 progenies, 171 of which are reproducing. Overall, the population increased by 1781% in the ten years. Plants that were planted on a rocky slope or a boulder heap in the new habitat, where soil was available, grew better than plants in rock faces without soil. In contrast, in the rock faces, where substrate was not covered with autumn foliage, more juveniles established. The distance between juveniles and mother plants rarely exceeded three meters, which indicates a limited dispersal potential of the hart’s tongue fern and may explain together with low diaspore pressure as a result of local rarity of the species that the dolina had not been colonized spontaneously. We conclude that transplantations of adult plants or introduction of spores are a suitable measure for preserving hart’s tongue fern populations that are endangered by destruction. In the long run, however, such measures cannot compensate for ongoing destruction of natural habitats by mining activities in the gypsum karst region at the southern edge of the Harz Mountains.