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Appendiceal cancer is a rare, orphan disease with no therapies currently approved by the FDA for its treatment. Given the limited data regarding drug efficacy, these tumors have historically been treated with chemotherapy designed for colon cancer. However, an overwhelming body of molecular data has demonstrated that appendiceal adenocarcinoma is a distinct entity with key molecular differences from colon cancer, notably rare APC mutation. Recognizing that APC loss-of-function is thought to contribute to taxane resistance and that taxanes are effective in the treatment of other gastrointestinal tumors, including gastric, esophageal, and small bowel adenocarcinoma, we completed a single-center retrospective study to assess efficacy. In a cohort of 13 patients with metastatic appendiceal adenocarcinoma, treated with taxane chemotherapy the median overall survival was 8.8 months. Of 10 evaluable patients, we observed 3 responses, 4 patients with stable disease, and 3 with progression (30% response rate, 70% disease control rate). The results of this study showing activity of taxane-based chemotherapy in appendiceal adenocarcinoma support further clinical investigation of taxane therapy in this orphan disease., (© The Author(s) 2023. Published by Oxford University Press.)

The existence of semelparity or "big bang" reproduction (reproducing only once in a lifetime) and iteroparity (reproducing more than once in a lifetime) has led to many questions investigating the evolution or persistence of these strategies. Here we investigate semelparity and iteroparity for their evolutionary importance. A mathematical model is used to illustrate how a population's ability to evolve depends on this life-history trait, and how this rate of evolution impacts the individual. We find that the ability of a trait to evolve is greater toward a semelparous strategy and this expresses a fitness advantage. This leads to an optimality between survival, population tracking ability, and lifetime fecundity.