Survival April May 2023

Survival, the IISS’s bimonthly journal, challenges conventional wisdom and brings fresh, often controversial, perspectives on strategic issues of the moment. In this issue: Franz-Stefan Gady and Michael Kofman assess that Ukraine will not be able to avoid attrition in its military strategy against Russia Nigel Gould-Davies assesses that Vladimir Putin’s priority has shifted from demobilising the population from politics to mobilising it behind the war Bastian Giegerich and Ben Schreer judge that Germany still requires significant changes to its defence and foreign policies for Zeitenwende to be meaningful Lynn Kuok believes that framing great-power competition as an ideological struggle is counterproductive to the United States’ partnerships in the Asia-Pacific Adam Mount observes that a fixation on nuclear assurance is harming the military alliance between the United States and South Korea And seven more thought-provoking pieces, as well as our regular Book Reviews and Noteworthy column. Editor: Dr Dana Allin Managing Editor: Jonathan Stevenson Associate Editor: Carolyn West Editorial Assistant: Charlie Zawadzki

Survival, the IISS's bimonthly journal, challenges conventional wisdom and brings fresh, often controversial, perspectives on strategic issues of the moment. In this issue: François Heisbourg argues that the COVID-19 pandemic has reinforced the power of the state in its traditional role as protector of society from outside threats Lawrence Freedman assesses that the UK misjudged the speed and severity of the pandemic, but ultimately followed the science Gigi Kwik Gronvall describes the extraordinary global mobilisation of the scientific community as a source of hope amid the pandemic Mark Fitzpatrick warns that US sanctions against Iran not only damage America's reputation, but also violate its moral duty to prevent further deaths of Iranians from COVID-19 And eight more thought-provoking pieces, as well as our regular book reviews and noteworthy column

We are delighted to present the Frontiers in Oncology "Women in Breast Cancer” Volume II series of article collections. At present, less than 30% of researchers worldwide are women. Long-standing biases and gender stereotypes are discouraging girls and women away from science-related fields, and STEM research in particular. Science and gender equality are, however, essential to ensure sustainable development as highlighted by UNESCO. In order to change traditional mindsets, gender equality must be promoted, stereotypes defeated, and girls and women should be encouraged to pursue STEM careers.

One of the great challenges in ecophysiology is linking physiological measures in wild animal populations with changes in individual fitness. Physiological variables that indicate nutritional state, stress, disease, or injury are used extensively in veterinary practice and captive settings to assess the health and likelihood of reproductive success of many animals. The development and refinement of sampling methods that limit disturbance of animals, coupled with advancements in analytical methods have allowed researchers to begin to examine the relevance of these physiological parameters in wild animals for predicting population trends and response to environmental perturbations. However, despite extensive research in this field, consistent correlations between fitness and/or population health and physiological measures remain rare.

Immune checkpoint inhibitors (ICI), such as anti-CTLA-4 and anti-PD-1/PD-L, have demonstrated significant clinical effects on the neutralization of immunosuppressive mechanisms in the tumor microenvironment (TME). Over the years, tremendous advances have been made in cancer immunotherapy, yet we are far from discovering the cure for the disease.

Genitourinary tumors consist of a large variety of malignancies located in the urinary and the reproductive systems, mainly including prostate cancer, bladder cancer, and renal tumors. Apart from surgeries, various systemic treatments have been used for the whole-course management of genitourinary tumors, including radiation therapy, chemotherapy, and hormonal therapy. However, the characteristics of progression, metastasis, and drug resistance deriving from tumors require and breed novel treatments. Furthermore, exploring biomarkers of genitourinary tumors at the early stage is also beneficial to strengthen the management of patients with tumors. Additionally, the diagnostic and prognostic value of the potential biomarkers for immunotherapy and combined therapy of genitourinary tumors are underexplored. On the basis of precision treatments, the advent of immune-based therapies, including immune checkpoint inhibitors (ICIs, antibodies targeting PD-L1 /PD-1 and CTLA-4 pathways), tumor vaccines, and other therapies, has extended the scope of treatment modalities. FDA has until now approved the clinical application of immune checkpoint inhibitors in a wide range of diseases including some types of genitourinary tumors, whereas not all patients with genitourinary tumors are suitable for immune-based therapies, therefore, the understanding of its underlying mechanism is key to develop effective treatments based on current ICI-based immunotherapy.

Breast cancer is a highly heterogeneous disease. Despite advances in early detection and treatment, breast cancer (BC) is the leading cause of cancer death in women worldwide. Heterogeneity negatively affects a patient’s prognosis, treatment sensitivity, and clinical outcome. In particular, the development of drug resistance mechanisms and the failure of anticancer drugs (initially or subsequently) could lie in the heterogeneity among BC patients and tumors. The major international guidelines have adopted an immunophenotypic sub-classification of BC to maximize patient eligibility for personalized therapy but do not take into account the extreme diversity existing between breast tumors (intratumor heterogeneity).