487 Background: Tumors deficient in DNA mismatch repair (dMMR) exhibit a microsatellite unstable phenotype characterized by high tumor mutational burden and an immunogenic tumor microenvironment. Despite the histology-agnostic approval of pembrolizumab for advanced dMMR/MSI cancers, responsiveness of dMMR/MSI upper tract urothelial cancers (UTUC) to immune checkpoint (IC) blockade remains largely unknown. Methods: Consecutive records of patients (pts) from a single institution with locally advanced unresectable or metastatic dMMR/MSI UTUC who received IC therapy were analyzed. The primary endpoint was assessment of objective response rate (ORR) using RECIST v1.1. Secondary endpoints were progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier technique. dMMR/MSI status was evaluated by immunohistochemistry (IHC) and/or polymerase chain reaction (PCR). Results: Ten pts were identified with locally advanced unresectable (N = 3) or metastatic (N = 7) dMMR/MSI UTUC who received therapy with IC blockade (pembrolizumab = 7, nivolumab = 2, atezolizumab = 1). Median age was 65.5 (range = 46 – 90). Six pts were male. Seven pts had germline dMMR. MSI was detected by PCR in three pts and dMMR by IHC in seven pts (PMS2/MLH1 loss = 4, MSH2 loss = 1, MLH1 loss = 1, MSH6 loss = 1). Five pts received systemic chemotherapy (2 cisplatin based, 1 carboplatin based, 2 other) prior to IC therapy with two pts (40%) achieving partial response (PR). At a median follow-up of 15.5 months (range: 2 – 43 months), all pts were alive, and none experienced disease progression. PFS and OS at 15.5 months were 100%. The observed ORR was 90% (CI, 55.5%, 99.8%), including 8 pts who achieved complete remission (CR). The median time to best response was 4 months (range: 2 – 8 months). Toxicity leading to treatment discontinuation: 1 (grade 3) pancytopenia, 1 (grade 2) pneumonitis, 1 (grade 2) SICCA-like symptoms. Conclusions: Immunotherapy with IC inhibitors demonstrates excellent clinical activity in advanced dMMR/MSI UTUC. Further studies integrating these agents earlier in the disease course are warranted in this rare but important subgroup. Given the extremely high complete response rate in this population consideration of preference to IC therapy as initial therapy should be entertained if these findings are validated.

e10214th International Congress on Infectious Diseases (ICID) Abstracts demic. The last of these is called Swine flue (influenza A H1N1), which since its inception has caused great alarm, high morbidity and mortality especially in pregnant women. This is a sample of the features of the disease in Dominican Republic.Dominican Republic is a tropical country located in the Caribbean that receive substantial annual number of tourists, which makes influenza outbreaks throughout the year: both seasonal peaks in the northern and southern hemisphere.Methods: The Epidemiology National Program starts a surveillance since the epidemic arise at level 5, at epidemiological week 16.Diagnosis confirmation was made with rt-PCR for A H1N1 to all symptomatic respiratory cases.Results: Until the 40th epidemiology week, we have 2,664 suspicious cases, 997 (37%) hospitalized, 441 confirmed cases, from this 191 (45%) hospitalized, and 22 (5%) death, 76 (17%) cases were pregnant women with 16% mortality.Clinical manifestations were: fever (94%), cough (89%), nasal congestion (76%), headache (71%), muscle pain (67%), sore throat (60%), dyspnoea (45%), nausea (25%), rales (21%), vomiting (18%) and diarrhoea (11%).Pregnancy was one of the more important risk factor associated with mortality.Necropsy findings where: edema, hemorrhage and necrosis in lung tissues, frequently associate with intravascular thrombosis.High mortality was cause due a delay in search of medical attention and no suspected diagnosis from health cares personel.Conclusion: It must be increased the Primary Care Services to obtain an early diagnosis of the disease, and began the antiviral treatment in high risk populations, when this pathology is suspected, mostly in pregnant women.

Conclusion and relevance The number of PI made in the two periods was similar but the CDSS tool allowed pharmacists to detect certain types of DRP that use of the CPOE alone did not allow. Moreover, the use of this tool optimised the pharmacist's medical prescription review time and facilitated the PI registration task. To increase the usefulness of the CDSS it is necessary to increase the number of relevant alerts introduced in this application.

Conclusion and relevance Considering the positive results obtained so far, the study of HIPEC with CRS in peritoneal carcinoma continues, to evaluate its effectiveness. The role of the pharmacist was important in participating in the multidisciplinary team in terms of eligibility of patients for treatment, to prepare oncological therapies and in processing the evaluation data.

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