Background: Few data are available on the rate and characteristics of thromboembolic complications in hospitalized patients with COVID-19. Methods: We studied consecutive symptomatic patients with laboratory-proven COVID-19 admitted to a university hospital in Milan, Italy (13.02.2020Italy (13.02. -10.04.2020. The primary outcome was any thromboembolic complication, including venous thromboembolism (VTE), ischemic stroke, and acute coronary syndrome (ACS)/ myocardial infarction (MI). Secondary outcome was overt disseminated intravascular coagulation (DIC). Results: We included 388 patients (median age 66 years, 68% men, 16% requiring intensive care [ICU]). Thromboprophylaxis was used in 100% of ICU patients and 75% of those on the general ward. Thromboembolic events occurred in 28 (7.7% of closed cases; 95%CI 5.4%-11.0%), corresponding to a cumulative rate of 21% (27.6% ICU, 6.6% general ward). Half of the thromboembolic events were diagnosed within 24 h of hospital admission. Forty-four patients underwent VTE imaging tests and VTE was confirmed in 16 (36%). Computed tomography pulmonary angiography (CTPA) was performed in 30 patients, corresponding to 7.7% of total, and pulmonary embolism was confirmed in 10 (33% of CTPA). The rate of ischemic stroke and ACS/MI was 2.5% and 1.1%, respectively. Overt DIC was present in 8 (2.2%) patients. Conclusions: The high number of arterial and, in particular, venous thromboembolic events diagnosed within 24 h of admission and the high rate of positive VTE imaging tests among the few COVID-19 patients tested suggest that there is an urgent need to improve specific VTE diagnostic strategies and investigate the efficacy and safety of thromboprophylaxis in ambulatory COVID-19 patients.

The SARS-CoV-2 pandemic significantly affected oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncologic features to severity and mortality from COVID-19 and little guidance as to the role of anticancer and anti-COVID-19 therapy in this population. In a multicenter study of 890 patients with cancer with confirmed COVID-19, we demonstrated a worsening gradient of mortality from breast cancer to hematologic malignancies and showed that male gender, older age, and number of comorbidities identify a subset of patients with significantly worse mortality rates from COVID-19. Provision of chemotherapy, targeted therapy, or immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk stratification of patients and supports further research into emerging anti-COVID-19 therapeutics in SARS-CoV-2-infected patients with cancer. SIGNIFICANCE: In this observational study of 890 patients with cancer diagnosed with SARS-CoV-2, mortality was 33.6% and predicted by male gender, age ≥65, and comorbidity burden. Delivery of cancer therapy was not detrimental to severity or mortality from COVID-19. These patients should be the focus of shielding efforts during the SARS-CoV-2 pandemic. Research.

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This is the largest phase II study in chordoma to date. It confirms anecdotal evidence that imatinib has antitumor activity in this orphan disease, and therefore, it is worth further investigation.

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Background: There is uncertainty as to the contribution of cancer patients' features on severity and mortality from Covid-19 and little guidance as to the role of anticancer and anti-Covid-19 therapy in this population.Methods: OnCovid is a retrospective observational study conducted across 19 European centers that recruited cancer patients aged >18 and diagnosed with Covid-19 between 26/02 and 01/04/2020. Uni-and multivariable regression models were used to evaluate predictors of Covid-19 severity and mortality.Results: We identified 890 patients from UK (n¼218, 24%), Italy (n¼343, 37%), Spain (n¼323, 36%) and Germany (n¼6, 1%). Most patients were male (n¼503, 56%) had a diagnosis of solid malignancy (n¼753, 84%) and 556 (62%) had active disease. Mean (AESD) patient age was 68AE13 years, and 670 (75%) had >1 co-morbidity, most commonly hypertension (n¼386, 43%). Commonest presenting symptoms were fever (n¼569, 63%) and cough (n¼448, 50%), beginning 6.3 (AE9.5 SD) days before diagnosis. Most patients (n¼565, 63%) had >1 complication from Covid-19, including respiratory failure (n¼527, 59%) and acute respiratory distress syndrome (n¼127, 22%). In total, 110 patients (14%) were escalated to high-dependency or intensive care. At time of analysis, 299 patients had died (33%). Multi-variate logistic regression identified male gender, age>65 (p<0.0001) presence of >2 comorbidities (p¼0.001) active malignancy (p¼0.07) as predictors of complicated Covid-19. Mortality was associated with active malignancy (p<0.0001), age>65 and co-morbid burden (p¼0.002). Provision of chemotherapy, targeted therapy or immunotherapy was not associated with higher mortality. Exposure to anti-malarials alone (chloroquine/ hydroxychloroquine, n¼182, p<0.001) or in combination with anti-virals (n¼195, p<0.001) or tocilizumab (n¼51, p¼0.004) was associated with improved mortality compared to patients who did not receive any of these therapies (n¼446) independent of patients' gender, age, tumour stage and severity of Covid-19.Conclusions: This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and supports further research into emerging anti Covid-19 therapeutics in SARS-Cov-2 infected cancer patients. Clinical trial identification: NCT04393974.Legal entity responsible for the study: Imperial College London.

This series, in which an aggressive surgical policy was adopted along with extensive pathologic sampling, shows that RPS has a high rate of viscera infiltration. This growth pattern is characteristic of well-differentiated liposarcoma too. These pathologic data should be considered when planning surgical strategy.

Intensive HD-CT seems to enhance the response rate and survival when compared with conventional treatment in poor-prognosis pPNET. The poor results of this treatment in RMS and DSRCT do not support the inclusion of such an approach in these patient subsets. No definitive conclusions can currently be drawn concerning the clinical implications of the detection of fusion transcripts during treatment or follow-up.