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Background: Over the last few years, the introduction of newer systemic therapies (e.g. CDKi) significantly changed the treatment paradigm of patients (pts) with MBC. The purpose of this work is to evaluate the impact of CDKi introduction in clinical practice in terms of medical oncology workload. Methods: We examined a consecutive series of 492 pts who received therapy for MBC in Academic Hospital of Udine during two historical cohorts A (2016-2017) and B (2018-2019), respectively before and after the first CDKi approval in Italy. Data about 2020 were not collected due to confounding effect of SARS-CoV-2 pandemic. Pts with no luminal MBC or enrolled in clinical trial were excluded. We performed descriptive analyses to examine any differences in terms of number and type of outpatient visits to the oncology department (i.e. planned visits, unplanned presentations and i.v. treatment sessions) between the two cohorts. Results: We analyzed a total number of 2,645 oncology activities deriving from 42 pts (cohort A) and 57 pts (cohort B) who started first line treatment for luminal MBC. Median age was 66 and 70 years respectively. In the first group, pts receiving chemotherapy were 23.8% and those treated with CDKi were 7,14%. In the second group, chemotherapy was administered in 22.8% of pts and CDKi in 49.12%. In cohort A, number of planned visits, unplanned presentations and i.v. treatment sessions were respectively 643, 82 and 418. In cohort B, number of planned visits, unplanned presentations and treatment sessions were 892, 114 and 496. During the period of observation (two years), for each pts mean number of planned visits were 15,30 (cohort A) vs 15,64 (cohort B), mean number of unplanned presentations were 1,95 (cohort A) vs 2 (cohort B), treatment i.v. sessions were 9,9 (cohort A) vs 8,7 (cohort B). Conclusions: With the limits of a retrospective analysis, no differences were found between two cohorts of pts. Notably, there was a slight decrease of i.v. treatment sessions after CDKi introduction. Other analysis are ongoing to evaluate the workload in terms of instrumental and blood chemistry tests. This data further support the handy use of this drugs into clinical practice. Legal entity responsible for the study: Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Funding: Has not received any funding. Disclosure: M. Mansutti: Financial Interests, Institutional, Advisory Board: AstraZeneca;Financial Interests, Institutional, Advisory Board, invited speaker: Novartis;Financial Interests, Institutional, Advisory Board, invited speaker: Eli Lilly;Financial Interests, Institutional, Advisory Board, invited speaker: Pfizer;Financial Interests, Institutional, Advisory Board: MSD Italia;Financial Interests, Institutional, Advisory Board, invited speaker: EISAI;Financial Interests, Institutional, Advisory Board: Pierre Fabre;Financial Interests, Institutional, Advisory Board: Roche;Financial Interests, Institutional, Advisory Board: Celgene. All other authors have declared no conflicts of interest.

Background: The recent COVID-19 outbreak in Italy required timely adoption of efficient triage procedures (TPs) with the aim to minimize the risk of infection spreading in the hospitals We developed a written questionnaire (items explored: fever, respiratory symptoms, previous contacts or personal positivity for COVID-19) together with body temperature (BT) measurement, to intercept patients (pts) with suspect of COVID-19 infection Methods: We conducted a monocentric observational study of a consecutive series of outpatients with diagnosis of solid tumor, accessing the Day Unit of Oncology Department at Udine Academic Cancer Center (Northern Italy) from 30 March 2020 to 30 April 2020 In this abstract we present the preliminary results of the TPs performed until 10 April 2020 Results: 1054 TPs were performed out of 586 pts, with a median of 2 TPs per pt Median age was 64 9 years, males were 35 4% Overall, 82 5% of TPs were made because of access for therapy, 10 7% for programmed procedures, radiological exams or non-oncological consultations, 1 2% for unplanned presentation (e g urgencies) The stage of neoplasm was early in 30 7% and advanced in 69 3% of pts TPs were made in pts receiving chemotherapy (58 2%), immunotherapy (10 8%), targeted therapy (18 9%), other therapies (5 2%) and in pts without active oncological therapy (6 9%) The questionnaires resulted positive in 5 5% of cases;2 9% were positive for fever, 2 9% for respiratory symptoms, 0 1% for previous contact with a case of COVID-19 Concomitant presence of 2 or more items was observed in 0 5% of questionnaires Of note, 6 TPs required medical evaluation despite a negative questionnaire and were considered to be clinically suspect BT≥37°C was observed in 7 TPs Overall, the oncologic program was postponed in 0 9% of the TPs, while in 0 5% a test for SARS-CoV-2 was performed for clinical suspect: no one resulted positive At multivariate analysis, factors associated with positive triage were diagnosis of thoracic cancer (OR 2 06;95%CI 1 02-4 12;p=0 04) and prior test for SARS-CoV-2 (OR 2 81;95%CI 1 46-5 41;p=0 001) Conclusions: A well-structured triage for COVID-19 could reduce the risk for further spreading of infection in Oncology facilities with limited impact on scheduled activities Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: F Puglisi: Honoraria (self): MSD;Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Roche;Honoraria (self), Advisory/Consultancy: Eli Lilly;Honoraria (self): Takeda;Pfizer;Advisory/Consultancy: Amgen;Novartis;Pierre Fabre;Research grant/Funding (self): Astrazeneca;Eisai;Travel/Accommodation/Expenses: Celgene;Servier C Andreetta: Advisory/Consultancy: AstraZeneca;GlaxoSmithKline;MSD A M Minisini: Advisory/Consultancy: Novartis;MSD;Pierre Fabre G Fasola: Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb srl;Eli Lilly SpA ;Servier Italia SpA ;Speaker Bureau/Expert testimony: Astrazeneca;Travel/Accommodation/Expenses: Merck Sharp and Dohme S p A ;Boehringer-Ingelheim S p A All other authors have declared no conflicts of interest

Background Cancer multidisciplinary team meetings (MDMs) are commonly acknowledged as a good clinical practice. One of the roles of MDMs is to identify the best diagnostic and therapeutic strategies for patients (pts) with new diagnosis of early breast cancer (EBC). In this setting, the purpose of the study was to define whether there was agreement between the planned program (i.e. MDMs-based decision) and that actually applied (i.e. actual therapeutic choice, ATC). In addition, the study explored factors associated with discordance. Methods We conducted a monocentric retrospective study of a consecutive series of 291 pts with new diagnosis of EBC, discussed at MDMs at the University Hospital of Udine (Italy), from January 2017 to June 2018. Results Median age was 62 years (range 27-88 years). Among invasive EBC patients, the most frequent phenotype was luminal-A (38%), followed by luminal-B (33%), HER2-positive (12%) and triple negative (5%). Thirty-four pts (12%) had diagnosis of in situ carcinoma (DCIS). Median time from MDMs discussion to first oncological examination was two weeks. Rate of discordance between MDMs-based decision and final choice, during face to face consultation with the oncologist, was 15.8% (46/291). Among cases with discordance, 19 pts (41.3%) had age > 70 years; 8 pts (17%) had a diagnosis of DCIS, 13 pts (28%) luminal-B carcinoma, 12 pts (26%) luminal-A, 9 pts (20%) HER2-positive and 4 pts (9%) triple negative EBC. The most frequent reason for changing the MDMs-based program was clinical decision by the oncologist at the first evaluation (87%). Follow-up was preferred to the chemotherapy proposed within the MDMs by 15% of pts, and to the endocrine therapy in 39% cases (among these, 44.5% had diagnosis of DCIS). In our study 16/46 pts (35%) had a therapeutic change from chemotherapy to endocrine therapy: among these pts, 7/16 had a luminal-B and 6/16 had a HER2-positive disease. Further analysis aiming at evaluating variables which could predict discordance between MDMs proposal and face to face oncological consultation are ongoing. Conclusions The results of our study could be useful for enhance the role of MTD and identify unmet needs in decision making process in EBC. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Background Preclinical data have indicated a synergistic interaction between docetaxel and capecitabine by means of taxane-induced up-regulation of thymidine phosphorylase (TP). On the basis of such premises, we conducted a phase II trial to determine the activity and tolerability of weekly docetaxel plus capecitabine in patients with metastatic breast cancer (MBC). Furthermore, we explored the relationship between TP tumor expression and benefit from this regimen. Patients and methods Patients received docetaxel 36 mg/m2 i.v. on days 1, 8, and 15 and capecitabine orally 625 mg/m2 b.i.d. from days 8 to 21. Cycles were repeated every 4 weeks. In the correlative study, we evaluated the TP expression by immunohistochemistry and the TP messenger RNA expression by real-time RT–PCR in the primary tumor. Results Forty-seven women were enrolled. In the intention-to-treat analysis, objective responses were achieved in 24 patients (51%). Fourteen additional patients (30%) had stable disease. The median time to progression (TTP) was 6 months (range 1–44 months). Median survival was 17 months (range 1–48 months). Overall, the treatment was well tolerated. The most common clinical adverse events (all grades) were alopecia (55%), nail changes (53%), fatigue/asthenia (51%), nausea/vomiting (51%), neutropenia (49%), and neuropathy (49%). A significantly higher TTP was observed in patients with TP-positive tumors (log-rank test, P = 0.009). Interestingly, a subgroup analysis confirmed this TTP benefit in patients with TP-positive tumors obtaining a tumor response (log-rank test, P = 0.03), whereas the statistical significance was lost in nonresponders (log-rank test, P = 0.3). Conclusions This study indicates that a regimen with low doses of capecitabine plus weekly docetaxel is active against MBC. The correlative analysis provides preliminary evidence that TP expression may be a predictive marker for therapeutic benefit.