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Mairi W Lucas,1 Catherine M Kelly2 1Royal College of Surgeons in Ireland, St Stephen’s Green, Dublin, Ireland; 2Mater Private Hospital, Dublin, IrelandCorrespondence: Catherine M Kelly, Consultant Medical Oncologist, UCD Clinical Professor, Mater Private Hospital, Eccles Street, Dublin, Ireland, Email Catherine.kelly@ucd.ieAbstract: The neoadjuvant setting provides immense opportunities for translational research and drug development. The acceptance of pathological complete response (pCR) as a surrogate endpoint for clinical benefit has led to the widespread use of neoadjuvant treatment. Optimal neoadjuvant therapies are determined based on their ability to achieve the highest rates of pCR. Predicted rates of pCR for triple negative breast cancer (TNBC) treated with sequential taxane/anthracycline regimens range from 35% to 48%. With the addition of a platinum agent pCR rates of 55% are predicted. Further increases have been observed with the addition of immune checkpoint inhibitors to this standard chemotherapy backbone. In the pivotal KEYNOTE-522 clinical trial pCR rates of 65% and 69% were reported for chemotherapy plus pembrolizumab in the overall and PD-L1-positive subgroup respectively. The role of the neoadjuvant chemotherapy is less clear in hormone receptor (HR)-positive, human epidermal growth factor receptor-2 (HER2)-negative breast cancer. In general, HR–positive cancers have the least chance of achieving a pCR after neoadjuvant chemotherapy, especially if they are low-grade. If neoadjuvant chemotherapy is given for high-risk HR-positive, HER2-negative breast cancer, standard adjuvant anthracycline/taxane regimens are appropriate. Optimum endocrine therapy is the standard-of-care in the adjuvant setting regardless of pCR. There are several genomic signatures available to guide decisions regarding adjuvant chemotherapy use however these assays are not routinely used in the neoadjuvant setting. For high-risk patients meeting the criteria for the monarchE trial adjuvant abemaciclib in addition to endocrine therapy is associated with an improvement in disease free survival (DFS) at 3 years. Based on the OlympiA trial patients with germline BRCA mutations should be considered for adjuvant olaparib therapy. In this article we review neoadjuvant clinical trials that guide optimum treatment options for TNBC and HR-positive, HER2-negative breast cancer.Keywords: neoadjuvant, pathological complete response, platinum agents, immune checkpoint inhibitors, PARP inhibitors, endocrine therapy

Abstract We studied a previously almost unknown nocturnal mammal, an apparently undescribed species of tree hyrax (Dendrohyrax sp.) in the moist montane forests of Taita Hills, Kenya. We used thermal imaging to locate tree hyraxes, observe their behavior, and to identify woody plants most frequently visited by the selective browsers. We also documented acoustic behavior in forest fragments of different sizes. Data on calling type and frequency were analyzed together with lidar data to estimate population densities and to identify forest stand characteristics associated with large populations. Viable populations were found only in the largest forest fragments (> 90 ha), where tree hyraxes preferred most pristine forest stands with high, multilayered canopies. The estimated population sizes in smaller forest fragments were very limited, and hyraxes were heard to call only during late night and early morning hours, presumably in order to avoid detection. While we frequently recorded tree hyrax songs in the largest forest fragments, we almost never heard songs in the small ones. All remaining subpopulations of the Taita tree hyrax are under threat of human disturbance and further habitat deterioration. Conservation efforts should include protection of all remaining habitat patches, but also reforestation of former habitat is urgently needed.

Anthrax caused by Bacillus anthracis is an old and neglected zoonosis that continues to raise concerns in Southern Africa. In this study, twenty (20) slides with suspected isolates of B. anthracis from anthrax cases between 1990 and 2014 and two (2) from that of a vaccine strain were analysed using MLVA with 15 VNTRs and CanSNPs test. The results from the CanSNPs indicate that all anthrax outbreaks in Zambia between 1990 and 2014 were caused by the lineage A.Br.005/006 of the clade A. This indicates a common ancestral origin of the B. anthracis circulating in the country. This data has described several environmental, wildlife, livestock and human cases that occurred in a 24 year period, from the major areas where anthrax is endemic. The molecular characterization of isolates from anthrax outbreaks in Zambia has revealed a genetic structure in agreement with previous studies from neighbouring countries. Further studies are needed to elucidate how to better manage anthrax outbreaks and define the risk maps of Zambia.