An overview of biodiversity and conservation status of steppes of the Anatolian Biogeographical Region

The Anatolian Biogeographical Region is unique in the Palearctic realm, with high plant and butterfly species richness and populations of globally threatened birds, mammals and herptiles (amphibians and reptiles). It is a place of diverse land-use practices, dating back to the earliest farming practices in the world. Among 10,930 species of vascular plants, birds, butterflies, mammals and herptiles distributed in Turkey, we identified 1130 living predominantly in steppic environments and being classified either as threatened, near-threatened or data deficient at the national level, if not globally. A total of 28 effective protected areas were present in the region, covering 1.5 % of the 391,597 km(2) land area. Only 16.2 % of the threatened and near-threatened species (n = 809) were distributed within the protected area network, ranging from 94.1 % for birds to as low as 12.9 % for vascular plants. The total area of steppe and steppe forest vegetation has been reduced by at least 44 % of its former extent due to diverse habitat destructive activities. The most significant threats arise from unsustainable agricultural activities including overgrazing, conversion to croplands and afforestation. To maintain steppe diversity, we propose a "to-do list", including mainstreaming biodiversity, effective implementation of Turkey's Rangeland Act, conducting effective environmental impact assessments, establishing an effective site network for steppe biodiversity conservation and filling gaps in scientific knowledge

LID - 10.1016/j.euf.2020.09.010 [doi]

BACKGROUND: Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies in patients with locally advanced or metastatic platinum-resistant urothelial carcinoma. OBJECTIVE: To compare the real-life experience and data of clinical trials on ATZ treatment in metastatic urothelial carcinoma. DESIGN, SETTING, AND PARTICIPANTS: Patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy from an expanded access program were retrospectively studied. Data of patients were obtained from their files and hospital records. Safety was evaluated for patients treated with at least one cycle of ATZ. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint was objective response rate (ORR). The secondary endpoints are overall survival (OS), progression-free survival (PFS), duration of response, and safety profile of patients. Kaplan-Meier methods were used to calculate median follow-up and estimate PFS and OS. RESULTS AND LIMITATIONS: Data of 115 enrolled patients were analyzed. Most of the patients (92.3%, n = 106) had received chemotherapy regimen only once prior to ATZ. The median follow-up duration was 23.5 mo. The complete response rate, partial response rate, and ORR were 8.7% (n = 10), 20.0% (n = 23), and 28.7% (n = 33), respectively. The median duration of response was 20.4 mo (95% confidence interval [CI], 6.47-28.8). Of the 33 patients who responded to treatment, 60% (n = 20) had an ongoing response at the time of the analysis. PFS and OS with ATZ were 3.8 mo (95% CI, 2.25-5.49) and 9.8 mo (95% CI, 6.7-12.9), respectively. All-cause and any-grade adverse events were observed in 113 (98%) patients. Of the patients, 64% experienced a treatment-related adverse event of any grade and 24 (21.2%) had a grade 3-4 treatment-related adverse event. Limitations of the study included its retrospective design, and determination of treatment response based on clinical notes and local radiographic studies. CONCLUSIONS: In these real-life data, ATZ was effective and well tolerated in patients with metastatic urothelial carcinoma who have progressed with platinum-based first-line chemotherapy. ATZ is an effective and tolerable treatment for patients with locally advanced or metastatic platinum-resistant urothelial carcinoma in our study, similar to previously reported trials. PATIENT SUMMARY: Atezolizumab is effective and well-tolerated in patients with metastatic urothelial cancer who progressed with first-line chemotherapy, consistent with the outcomes of the previous clinical trials in this setting