PurposeThe prevalence of anemia ranges between 30% and 90% in cancer patients, affecting the health status, quality of life, and treatment outcome. Therefore, a proper diagnosis and management of anemia is crucial in these patients. Iron deficiency is diagnosed in~32%–60% of the cases. In this observational study, we evaluated the efficacy and safety of intravenous iron (ferric carboxymaltose [FCM], Ferinject®) in the treatment of iron-deficiency anemia in patients with gastrointestinal tumors undergoing palliative or adjuvant chemotherapy.Patients and methodsThirty patients with gastrointestinal tumors undergoing chemotherapy diagnosed with iron-deficiency anemia were included in the study and received at least one FCM administration. The need for iron replacement therapy was evaluated by the assessment of hemoglobin and iron status parameters, and patients could be treated with FCM during 12–14 weeks. Paired t-test approach was used to evaluate the mean differences between the baseline and the end of the study. A p-value of <0.05 was considered statistically significant.ResultsData showed that there was a statistically significant increase in the mean of hemoglobin (10.3 vs 11.2 g/dL), ferritin (230.3 vs 877.0 ng/mL), transferrin saturation (13.0% vs 19.7%), and serum iron (42.3 vs 59.6 mg/mL) from the baseline to the end of the study in cancer patients. Most of the patients (n=25) were only administered one dose of FCM. There was one FCM-related adverse event during the study.ConclusionFCM was well tolerated and had a positive impact in the treatment of iron-deficiency anemia in patients with gastrointestinal tract tumors undergoing chemotherapy.

Breast cancer is the most prevalent cancer and the leading cause of cancer-related death among females worldwide. Despite all therapeutic advances, metastatic breast cancer is still associated with a median overall survival of 3 years. Alongside this condition, bladder metastases of solid neoplasms are rarely observed. In this setting, the secondary bladder tumors with an origin in breast cancer occur in 2.5% of cases in some series. The authors report the case of a 68-year-old female with stage IV breast cancer (bone metastasis) treated with anastrozole, who presented with peripheral edema and renal failure with a creatinine clearance of 12.5 mL/min. After hospital admission, the patient was diagnosed with new liver lesions and bladder involvement with bilateral hydronephrosis. She was submitted to bilateral percutaneous nephrostomies with improvement in renal function. There was a high suspicion of primary bladder tumor in this patient who was a previous smoker, with a family history of high-grade bladder carcinoma (her mother). Liver and transurethral biopsies were performed, and histological examination was consistent with breast cancer metastases. The patient started treatment with capecitabine and denosumab, remaining clinically stable after 3 months of treatment. This case report underlines the diagnostic challenges of bladder metastases in a patient with multiple risk factors for bladder cancer and without evident clinical symptoms. Even though this is a rare entity, the close surveillance of metastatic breast cancer is important in order to allow early detection of new metastatic sites and their treatment to preserve the quality of life in these patients.

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 nononcological 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. BT37 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; p¼0.04) and prior test for SARS-CoV-2 (OR 2.81; 95%CI 1.46-5.41; p¼0.001).

The PDGFRA mutation was in exon 18. No data is available on genetic syndromes. 24 patients (58.4%) received curative-intent treatment with 3 (12.5%) subsequently had local recurrences. 14 (58.3%) received imatinib in a neoadjuvant/adjuvant setting. 17 patients (41.5%) received palliative-intent treatment with 13 (76.4%) receiving palliative imatinib. 9 (52.9%) had Sunitinib after progression. The median follow-up was 48 months (0-165). 6 patients (14.6%) had demised. Median OS for all patients was 162.0 months (95% CI: 80.8-243.2) with no significant differences with regards to age (p¼0.07), gender (p¼0.91), presence of a sensitising mutation (KIT Exon 9 and 11) (p¼0.26), and treatment intent (p¼0.2). A significant OS difference was found between patients undergoing curative or palliative intent (162.0 vs 65.0 months, p¼0.001) and in patients with different primary tumor location (p¼0.029). Out of the 6 patients with uncommon primary tumor locations, 3 had demised. Conclusions: AYA GISTs differ from adult GIST. In our series, 61.0% had tumor mutation analysis performed. AYA GIST also has a higher rate of small intestine primary. Further studies are needed to evaluate the low mutation and genetic testing and clinico-molecular differences to better understand how these affect outcomes. Legal entity responsible for the study: The authors.

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