Combined bevacizumab and metronomic oral cyclophosphamide is a safe and effective regimen for heavily pre-treated ovarian cancer patients. Further research is needed on predictive factors to screen for those patients who will benefit from anti-angiogenic therapy.

Background: This study analyses the levels of distress and related psychosocial factors among cancer patients during the Spanish lockdown due to COVID-19. Methods: A total of 2,779 cancer patients took part in an observational and lateral study carried out between April 16, 2020 and April 25, 2020. An online questionnaire was distributed including distress-related variables, demographic variables, clinical variables about their oncological condition, socioeconomic variables and variables related to information management and social communication. Distress was measured according to the Kessler (K-6) scale, and its relationship with the remaining variables was analyzed by logistic regression. Results: 33.5% of the patients yielded levels of clinical distress during lockdown. Younger patients and women yielded significantly higher levels of distress. High distress levels were generally associated with the following factors: trust in medical institutions; deterioration of the household's financial conditions; and media management of the information about the pandemic. Conclusions: The lockdown triggered by COVID-19 increased distress among cancer patients, and this can be significantly related to a number of variables. Identifying distress, and said factors, at an early stage can help to develop mitigation strategies. Similarly, early detection can help to improve the way information is shared with patients, offer them support and resources and direct them to psychosocial services, increasing the patient's ability to return to normal after COVID-19.

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Introduction: Israel contains within it a unique variety of ethnic and religious groups with variable set of convictions and values. Integrating palliative care approach in routine care of patients with hematological malignancies is challenging although published data supports this approach that results in improved patient quality of life. In this study we tested the effect of this approach on adherence to the planned treatment plan and hospital admissions for symptoms management. Methods: Patients with hematological malignancies treated in Carmel Medical Center, Haifa, Israel were enrolled in our integrative palliative care program. All patients were diagnosed with hematological malignancy. Patients were in various stages of disease - during diagnosis, active treatment or follow-up. Patients were evaluated by a multidisciplinary team including a palliative care physician, palliative care nurse, treating hematologist and a social worker. Evaluation included recognition of patient's unique characteristics and identifying needs and areas for intervention. A patient specific plan was formulated based on needs and social background. We measured patient's satisfaction using a specific questioner. Adherence to care was measured by the percentage of patients that had to change treatment plan due to side effects. We measured hospital admissions for symptoms management during treatment. Results: Fifty patients were enrolled in our integrated program. The mean age of our patients was 68, 46% were women, 62% were immigrants to Israel, 12% were Arab Israelis, and 64% were married. Most patients evaluated in the clinic were prior to initiating chemotherapy treatment for the underlying disease (70%). Most common patients main complain was depression and anxiety (42%) followed by pain (26%). Other complains included GI symptoms (12%), fatigue and malaise (10%), peripheral neuropathy (6%), none (4%). Most patients were treated with pharmacological interventions (66%). Patient comprehension of their disease and treatment plan was significantly improved (81%) following palliative care intervention. The palliative care intervention significantly improved patient symptoms and 81% reported significant improvement. None of the patients had to stop or change treatment due to symptoms or side effects from therapy. A significant decrease in ED visits or inpatients admissions was noted. Over a period of 6 months there was 80% decrease in ED visits or inpatients admission for symptoms management (p=0.04). Conclusions: Integrating palliative care in the outpatient hematology clinic significantly increase patients satisfaction, adherence to care and decrease hospital admissions for symptoms management. Depression and anxiety are very significant symptoms in patients prior to chemotherapy initiation and should be addressed to improve patient care. This approach has tremendous value in treating newly diagnosed patients with hematological malignancies. Disclosures No relevant conflicts of interest to declare.

Cutaneous melanoma (CM) is an aggressive malignant tumor of epidermal melanocytes for which treatment options and survival chances decrease dramatically when metastatic. To date, immunotherapy is becoming a new standard treatment for CM although less than 30% of the patients´ response positively. Therefore, there is a strong interest to identify response predictors and molecular pathways that might lead to therapy failure. Two novel biomarker sources are LncRNA and CircRNA which can function as natural sponges of miRNA as competitive endogenous RNAs (ceRNA) or can associate to RNA-Binding Proteins (RBP) to regulate gene expression. Moreover, several studies have revealed that ceRNA networks are implicated in tumorigenic processes. Considering this, we set to interrogate the role of the ceRNA in the prediction of response to CM immunotherapy. In this pilot study, differential expression was quantified by RNA-seq in 16 FFPE pre-treatment metastatic samples from CM patients treated with Nivolumab. Total RNA isolation was performed from 10 µm slides (4) with RNAeasy FFPE kit. Total RNAseq was done with Truseq Stranded RNA gold kit, and libraries were sequenced on Illumina Nextseq 550. LncRNA were obtained by STARs alignment and explored on LncATLAS. To assess the presence of high confident cirRNA we used 5 different pipelines with a minimum filtering cut-off of 2 junction reads in at least 2 samples and with at least 3 software. Deseq2 pipeline of total mapped reads was used to perform differential expression. We identified 23 circRNA and 74 lncRNA differentially expressed (DE) with a fold change of 1.5 and a p value < 0,01. Ingenuity pathway analysis was carried out to generate DE ceRNA-mRNA networks and associated RBP networks. Interestingly, in the DE ceRNA-mRNA networks, most of the 47 significant canonical pathways comprised immunological pathways such the antigen presentation pathway, Th1 and Th2 activation pathways and PD1-PDL1 cancer immunotherapy pathways. Regarding the DE ceRNA associated RBP networks, HOTAIR regulatory pathway and senescence as well as G1/S cell cycle checkpoint regulator pathways were enriched. Furthermore, we were able to predict the interaction of the DE ceRNA with the activation of key promoters of the immune response such as IL27 (Interleukin 27), EIB3 (Epstein-Barr Virus Induced 3), IL2 (Interleukin 2) and IFNA2 (Interferon Alpha2), as well as the inhibition of negative immune regulators such as SAFB2 (Distal-Less Homeobox 2) and FOXD1 (Forkhead Box D1). In conclusion, we have evidenced for the first time the potential utility of ceRNA as immunotherapy predictors. We have generated a response signature of ceRNA expression and used network analysis to associate them with specific key modulators of the immune response. This study opens a new venue for the investigation of the role of these regulatory ncRNA in the resistance to immunotherapy in cancer. Citation Format: Javier Oliver, Juan Luis Onieva, Maria Garrido-Barros, Alicia Garrido-Aranda, Vanessa De Luque, Martina Alvarez, Alfonso Sanchez, Elisabeth Perez, Patricia Chaves, Maria Jose Lozano, Miguel Berciano, Manolo Cobo, Emilio Alba, Antonio Rueda, Isabel Barragan. Association of ceRNA dysregulation with clinical Response to Immunotherapy in cutaneous melanoma (CM) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1538.

La novela de Evelyn Retorno a Brideshead, publicada en 1945, analiza la transformación institucional del Reino Unido desde una visión imperial a la fundación de su contemporáneo Estado social, con Charles Ryder y su asistente Hooper como símbolos de una nueva cultura política democrática: la cultura de los derechos sociales,