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Background: The coronavirus disease 2019 (COVID-19) outbreak has been declared global pandemic and Italy is one of the first and heavily affected countries Cancer patients are a population at higher risk from COVID-19 both for intrinsic fragility bound to their underlying disease and oncologic treatment delay Aim of our survey was to investigate how cancer patients perceived their health condition, their clinical management and information communication by their medical oncologists during the pandemic Methods: Between 15th April and 1st May 2020 a survey was submitted to cancer patients under treatment at hospitals of Marche Region which had been invested by the pandemic It consisted of questions regarding the perception of personal safety, continuity of cancer care and information quality provided by the Oncology Department and individual psychological distress Results: A total of 661 patients participated in the survey;60 2% was female and 40 4% was aged between 46 and 65 Almost all of the attendees (97 7%) stated that the Oncologic Department complied with the appropriate safety standards and 78% was reassured about their concerns during the medical interview, but 41% was worried of being at higher risk of infection upon entry into the Oncology Department and 53 3% felt being at greater risk of infection because of chemotherapy treatment in general The majority of the participants (62 2%) felt that postponing cancer treatment could reduce its efficacy, however 80% declared they did not feel abandoned at the time of treatment delay 79 4% of the attendees felt more worried for their underlying disease in this emergency situation, but the mood worsened only for 34 2% of the participants Conclusions: Our survey reveals that Oncology Departments have been considered worthy of the emergency in terms of safety standards and care management by cancer patients However, the majority of attendees perceived the mutual negative influence between their underlying oncologic disease and risk of Sars-CoV-2 infection and manifested concerns about their health condition highlighting the need for special measures to ensure safe continuity of care Legal entity responsible for the study: Universita Politecnica delle Marche- AOU Ospedali Riuniti di Ancona Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest

Background The phase IIIb international study C-1 (NCT02941926) aims to assess the safety and efficacy of RIBO + LET in men and women who have not received prior ET for HR+, HER2– ABC. Overall more than 3000 pts were enrolled. Here we present interim efficacy and safety results from the Italian cohort. Methods Pts with HR+, HER2– ABC, ≤1 line of prior chemotherapy, and no prior ET for ABC received RIBO (600 mg/day, 3 wk on/1 wk off) + LET (2.5 mg/day). Men and premenopausal women received concomitant goserelin. The primary endpoint was safety and tolerability. Secondary endpoints included time to progression (TTP), overall response rate (ORR) and clinical benefit rate (CBR). Results From April 2017, to December 2017, 554 pts were enrolled in the C-1 trial in Italy. Median age was 58 years (range 20–87); 1,1% (6) of pts were male, 29,1% were premenopausal women and 69.3% post-menopausal. 2,3%(13) of pts presented CNS metastases and 4,5% (25) skin involvement at study entry. At the cut-off date for this Analysis (August 8, 2018) 66,1% of the pts were still on treatment, 29,8% discontinued, mainly for progression (18,4%) or AEs (10,3 %). The most common all-grade any-cause AEs were neutropenia (69,7%), nausea (29,6%), and leukopenia (28,7%). Grade 3 or 4 elevations in ALT and AST levels were reported in 6,4% and 4,3%, respectively. Prolongation of the QTcF interval to more than 480 msec occurred in 3.1% of patients. 30,3% of patients required a dose reduction (24% one dose, 24,9% due to AEs). ORR was 20,4% (95% CI, 17,1%-24%) and CBR was 69,7% (95% CI, 65,7%-73,5%). TTP was not reached. Conclusions This interim analysis confirm the predictable and manageable safety profile of RIBO in combination with LET as first-line treatment for HR+, HER2– ABC. The Italian C-1 cohort is the largest hormono-sensitive Italian population ever published with a CDK 4/6 inhibitor, including 6 male patients and 13 patients with CNS metastases that could give valuable information on this patient’s subgroups that still represent an unmet need. Clinical trial identification EudraCT: 2016-003467-19, release date 2016-12-08 Protocol n. CLEE011A2404 NCT02941926. Legal entity responsible for the study Novartis Pharma AG. Funding Novartis Pharma AG. Disclosure M. De Laurentiis: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Celgene; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: astrazeneca; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: eisai; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Eli Lilly; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen. M. Mazza: Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): istituto gentili; Honoraria (self): Celgene; Honoraria (self): astrazeneca. M. Mansutti: Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Celgene. R. Masetti: Honoraria (self), Advisory / Consultancy: genomic Health; Honoraria (self), Advisory / Consultancy: medtronic. Z. Ballatore: Honoraria (self), writing engagement and public speaking: Ipsen. R. Torrisi: Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: MSD. A. Michelotti: Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: astrazeneca; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: eisai; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Celgene; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: teva; Advisory / Consultancy: Pfizer. A. Zambelli: Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy: astrazeneca. D. Generali: Honoraria (self): Novartis; Honoraria (self): Lilly; Honoraria (self): Pfizer; Honoraria (self): Roche. P. Vici: Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Novartis; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer. A. Fabi: Honoraria (self), Speaker Bureau / Expert testimony: Roche; Honoraria (self), Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Speaker Bureau / Expert testimony: astrazeneca; Honoraria (self), Speaker Bureau / Expert testimony: Pfizer. P. Marchetti: Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: bms; Honoraria (self), Advisory / Consultancy: astrazeneca; Honoraria (self), Advisory / Consultancy: incyte; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: molteni; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: MSD. S. Spazzapan: Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Celgene; Travel / Accommodation / Expenses: gentili; Honoraria (self), Speaker Bureau / Expert testimony, Research grant / Funding (institution), principal investigator of trials: Novartis; Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Speaker Bureau / Expert testimony: Takeda; Honoraria (self), Speaker Bureau / Expert testimony: Pierre Fabre; Honoraria (self), Speaker Bureau / Expert testimony, Research grant / Funding (institution), Travel / Accommodation / Expenses, principal investigator of trials: Roche; Honoraria (self), Travel / Accommodation / Expenses: tesaro; Honoraria (self), Speaker Bureau / Expert testimony: astrazeneca; Research grant / Funding (institution), principal investigator of trials: abbvie. A. Frassoldati: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Speaker Bureau / Expert testimony, plus writing engagement: astrazeneca; Honoraria (self), Speaker Bureau / Expert testimony: Pfizer. G. Sarobba: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: teva. D. Grasso: Full / Part-time employment: Novartis; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: astrazeneca; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Celgene; Honoraria (self), Travel / Accommodation / Expenses: pierrefabre. C. Zamagni: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Celgene; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: astrazeneca; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: teva; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: istituto gentili; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: eisai; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Honoraria (self), Advisory / Consultancy: eliLilly; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: tesaro. All other authors have declared no conflicts of interest.

Aim: Neoadjuvant chemotherapy (NAC) is the standard of care for locally advanced breast cancers (BC). Based on previous studies high-lightening the potential role of baseline neutrophil to lymphocyte ratio (NLR) in predicting survival and mortality of patients with early breast cancer (BC), we aimed to investigate the association between pre-therapeutic NLR as a predictive marker for the pathologic response to NAC in patients with locally advanced breast cancer. Methods: We reviewed the records of consecutive patients undergoing NAC for locally advanced BC (stage I-III) following surgery at our Institution between January 2007 and December 2012. The NLR was measured before NAC and the pathologic responses to NAC were evaluated. NLR is calculated as absolute neutrophil count divided by absolute lymphocyte count. The cut-off value of 3 was decided as the maximum (sensitivity + specificity) point according to receiver operating characteristics curves. The difference among variables was calculated by chi-square test. Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan-Meier method. Results: A total of 86 patients were eligible for analysis: 56% of patients showed higher pre-treatment NLR. Median age at diagnosis was 50 years (range 28-75). Patients with higher pretherapeutic NLR showed a significant association with lobular histology (12.8% vs 1.1; p = 0.01), pre-NAC lymph node involvement (48.8% vs 29%; p = 0.04) and deaths (15.1% vs 3.5%; p = 0.04). 25.6% of patients had a pathological complete response (pCR) to NAC. There was no significant correlation between pCR and NLR (p = 0.7). Breast cancers with negative Her-2 status or positive progesterone receptor, were less likely to have a pCR to NAC (p = 0.0002 and p = 0.02, respectively). Univariate survival analysis revealed that NLR was not associated with DFS (p = 0.42) or OS (p = 0.13). Conclusions: Our results show that baseline NLR may play a potential role to assess tumor staging in locally advanced BC. Although baseline high pre-treatment NLR did not showed to be related with pCR, the trend of these patient with high pre-treatment NLR was worse than whom with lower NLR. In this setting, further validation and a feasibility study are required before it can be considered for clinical use. Disclosure: All authors have declared no conflicts of interest.

Aim: Many studies suggest that breast cancer prognosis may differ in women with BRCA germ-lines mutation compared with those with sporadic disease, but BRCA1 and BRCA2 subgroup' differences are still unclear. The aim of our survey was to highlight clinical outcomes of BRCA1 and BRCA2-related breast cancers in a consecutive monoinstitutional series of patients. Methods: We included all deleteriously mutated breast cancer patients who underwent genetic testing at the Genetic Oncology Center of the Marche Region from January 1996 to December 2013. Subgroup differences were analysed using Chi Square Test. Data were tested at a statistical significance level of p Results: 92 cases (84 female and 8 male) of hereditary breast cancer were included. BRCA1 and BRCA2-associated breast cancers were 46.7% and 52.2%, respectively, while one patient reported pathogenetic mutation in both genes. Median age at diagnosis was 44 years (range 22-79). Most of patients (62%) were 45 years or younger and in a pre-menopausal status (69.9%). Up to date, there were 17 deaths (11.6%). BRCA2-related breast cancer presented more often lympho-vascular invasion (35.4% vs 13.9%, p = 0.03) and positive estrogen (72% vs 16.7%, p Conclusions: Our study showed that tumor size and node status are strongly related to BRCA-associated breast cancer prognosis. These data are in accordance with other studies about sporadic breast cancers. At univariate analysis, the result of worse OS rate in BRCA2 carriers seems to reflect more adverse tumor characteristics than in BRCA1 tumors, such as lympho-vascular invasion which is related to higher risk of relapse and to a worse prognosis. Disclosure: All authors have declared no conflicts of interest.