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Background: On March 11, 2020, COVID-19 was declared a global pandemic Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this infection may remain asymptomatic The European Society of Medical Oncology and the Portuguese Health Authority recommended both a symptomatic survey and laboratory testing in all cancer patients (pts) undergoing immunosuppressive treatment (IT) The impact of this measure is still unknown We report our experience in a Portuguese center Methods: Since March 2020, a symptomatic survey has been performed at our institution before each hospital visit From April 6 through May 8, 2020, reverse-transcriptase polymerase chain reaction (RT-PCR) SARS-CoV-2 testing was added on cancer pts before undergoing IT The impact of this intervention was evaluated comparing the hospitalization rate of cancer pts due to COVID-19, before and after the introduction of RT-PCR testing Retrospective analysis of clinical data was performed Results: 444 tests were carried out on 244 pts and laboratory SARS-CoV-2 infection was confirmed in 11 (5%);5 were male, with a median age of 65 years [34-76] Breast and colorectal cancer were prevalent;2 pts had lung cancer;6 advanced disease Ongoing IT in these pts was temporarily suspended: 9 pts under chemotherapy, 1 atezolizumab and 1 rituximab Only 1 patient was symptomatic (9%) and previously hospitalized No admission due to COVID-19 was registered in this group Since March 7, 179 pts were admitted due to COVID-19 at our center: 12 were active cancer pts (6 7%) of which 4 were under IT 6 of the oncological pts passed away, all of them had advanced diseases, 1 was under IT Of the dead pts, lung and breast tumors were prevalent Among all COVID-19 hospitalizations, the prevalence of pts under IT was similar before and after the implementation of the RT-PCR testing (2 2% vs 2 4%) Conclusions: We found a significant percentage of active cancer pts diagnosed with asymptomatic COVID-19 Due to the small sample size of COVID-19 pts under IT, it is difficult to evaluate the impact of RT-PCR testing However, on a long-term analysis, this intervention may reduce the risk of severe complications related to COVID-19 in cancer pts Health education and dynamic organization are also important measures Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest

Background The immune checkpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC) had shown to increase progression-free survival (PFS) and overall survival (OS). The prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) are biomarkers easy to measure by blood tests and they had been studied as possible prognostic predictors in patients (pts) with various types of cancer treated with ICI. This study intends to analyze the impact of the NLR and PNI in pts with NSCLC treated with ICI. Methods Thirty-four pts with stage IV NSCLC that had started ICI in 1st and subsequent lines between 03/2016 and 06/2019 were retrospectively analyzed. The pre-treatment NLR and PNI were calculated and the cut-off 5 and 50 were respectively considered. The Kaplan-Meier method and Log Rank test and the Cox regression were used in survival analysis. Results Twenty-seven (79%) were male, with a median age of 67 (34-79) years; ECOG 0-1 (n = 30; 88%); stage IVA (n = 14; 41%); PD-L1 ≥50% (n = 18; 53%); NLR ≥5 (n = 13; 38%); PNI ≥50 (n = 14; 41%). Eleven pts (32%) were submitted to ICI in 1st line. The median follow-up time was 19,3 months (mo.). The median PFS was 6,1 mo. (95%CI 1,94-10,26) and median OS was 9,3 mo. (95%CI 0,31-18,29) - 16,5 mo. in 1st line vs 8,6 mo. in subsequent lines. The median PFS was superior in patients with PNI ≥50 (7,0 vs 2,1 mo., p = 0,039), but there weren’t differences considering the NLR. The median OS was also superior when PNI ≥50 (16,8 vs 6,7 mo., p = 0,019). In multivariate analysis (sex, age, 1st line, PD-L1, stage, ECOG, NLR and PNI), the mortality probability was superior in pts with ≥70 years [HR 6,14 (95%CI 1,49-25,39)]. Moreover, PD-L1 ≥50% [HR 0,09 (95%CI 0,01-0,52)], male sex [HR 0,03 (95%CI 0,004-0,24)], stage IVA [HR 0,26 (95%CI 0,07-0,997)] and PNI ≥50 [HR 0,15 (95%CI 0,03-0,69)] were associated to a reduced mortality risk. Conclusion PNI ≥50 was predictive of a better PFS and OS and the NLR wasnt a predictor of survival. Regarding OS, PNI ≥50 was an independent survival prognostic factor. In order to understand the impact of this biomarker in NSCLC treated with ICI, it is important to evaluate it in more studies with a larger population and prolonged follow-up time. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

We report on a 7-year-old girl with Ewing's Sarcoma (ES) who developed a poorly differentiated acute myeloid leukemia (AML-M0) 20 months after beginning the EW92 protocol for the treatment of the primary tumor. She received a total dose of 1500 mg of etoposide, a tumor cumulative radiation dose of 35Gy and granulocyte colony-stimulating factor (G-CSF) was as predicted in the protocol regimen. At onset of secondary malignancy her laboratorial analysis revealed immature blast cells characterized by CD34+/CD33-/a-MPO+ and a t(4;11)(q21;q23) abnormality. This serious complication of ES treatment, which associates etoposide, irradiation and G-CSF schedule, should be weighed against its therapeutic benefits.