BackgroundBeing “positive” has been one of the most frustrating words anyone could hear since the end of 2019. This word had been overused globally due to the high infectious nature of SARS-CoV-2. All citizens are at risk of being infected with SARS-CoV-2, but a red warning sign has been directed towards cancer and immune-compromised patients in particular. These groups of patients are not only more prone to catch the virus but also more predisposed to its deadly consequences, something that urged the research community to seek other effective and safe solutions that could be used as a protective measurement for cancer and autoimmune patients during the pandemic.AimThe authors aimed to turn the spotlight on specific herbal remedies that showed potential anticancer activity, immuno-modulatory roles, and promising anti-SARS-CoV-2 actions.MethodologyTo attain the purpose of the review, the research was conducted at the States National Library of Medicine (PubMed). To search databases, the descriptors used were as follows: “COVID-19”/”SARS-CoV-2”, “Herbal Drugs”, “Autoimmune diseases”, “Rheumatoid Arthritis”, “Asthma”, “Multiple Sclerosis”, “Systemic Lupus Erythematosus” “Nutraceuticals”, “Matcha”, “EGCG”, “Quercetin”, “Cancer”, and key molecular pathways.ResultsThis manuscript reviewed most of the herbal drugs that showed a triple action concerning anticancer, immunomodulation, and anti-SARS-CoV-2 activities. Special attention was directed towards “matcha” as a novel potential protective and therapeutic agent for cancer and immunocompromised patients during the SARS-CoV-2 pandemic.ConclusionThis review sheds light on the pivotal role of “matcha” as a tri-acting herbal tea having a potent antitumorigenic effect, immunomodulatory role, and proven anti-SARS-CoV-2 activity, thus providing a powerful shield for high-risk patients such as cancer and autoimmune patients during the pandemic.

analyzed for ESR1 mutations by next generation sequencing. The primary objective was to assess the progression-free survival (PFS) rate at six months. We applied a twostage design with a¼0.05, b¼0.20, P0¼0.4 and P1¼0.75 was applied, requiring at least 8 of 14 ESR1 mutant patients to be free of progression at 6 months on paclitaxel/bevacizumab. For P0, we assumed a 6-months PFS rate of 40% on fulvestrant, which is a commonly used treatment in these patients. Secondary outcomes were objective response rate (ORR) and overall survival (OS).Results: ESR1 mutations were detected in 20 (45%) baseline samples. The 6-month PFS rate was 83% for ESR1 wild-type patients versus 85% for ESR1 mutant patients (17/20). The median PFS was 8.6 months [95% confidence interval (CI), 8.2-9.1] for ESR1 wild-type patients versus 8.1 months [95% CI, 7.2-9.0] for ESR1 mutant patients [log rank P¼0.807]. The ORR was higher in ESR1 wild-type patients than in ESR1 mutant patients [75% vs 50%] although this percentage was not significant [P¼0.052]. The median OS was 24.8 months [95% confidence interval (CI), 17.4-32.2] for ESR1 wild-type patients versus 20.7 months [95% CI, 2.1-39.3] for ESR1 mutant patients [log rank P¼0.443].Conclusions: This explorative study indicates that in advanced breast cancer patients with ESR1 mutations in plasma it is worthwhile to start bevacizumab/paclitaxel as further treatment.Legal entity responsible for the study: Erasmus MC Cancer Institute.