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Background: Risks associated with COVID outbreak and consequent restrictive measures taken by the Government can cause concern and anxiety The impact on cancer patients (pts) may be even greater We investigated the influence of COVID pandemic on pts’ perceptions, opinions and feelings during the peak of the epidemic and after the loosening of the Government restrictions Methods: Multicenter, serial cross-sectional study conducted in 11 cancer centers located in the hardest hit Italian areas The study is composed by 2 surveys administered to unselected adult pts receiving onsite oncologic treatments: the first during the enforcement of containment measures against COVID spread;the second upon the loosening of Government restrictions A self-administered questionnaire composed by 11 closed questions (only 1 answer) was used At least 1000 pts per each survey were deemed necessary Multivariable logistic regression models will be used to identify factors associated to recorded perceptions and opinions Main outcomes are: 1) perception of the pandemic effect on feelings 2) perception of changes in the relationship with the medical team 3) opinions on healthcare reorganization and on the information campaign This study has been approved by all Ethical Commettees of the centers Results: The first survey was conducted between March 16th and April 30th 1027 questionnaires were collected Mean age was 64 yrs (SD 11 7), 58% were women, 49% had low educational level 80% and 20% received i v and oral treatment, respectively As for pts feelings, 45 5% indicated that their fears related to cancer increased because hope in recovery diminished (23%) Courage of coping with tumor was increased in 26%, unchanged in 64%;95% perceived a high availability of healthcare facilities and 97 6% declared confidence in the treating teams, while 65 3% stated that the information received from the Government and local bodies was confusing Conclusions: Although half of the pts had more fears and concerns about the epidemic, they feel reassured, maintain trust in healthcare facilities and a good communication with doctors and nurses Due to the epidemic course, the second survey could not yet be performed and data will be available by June Legal entity responsible for the study: Azienda Istituti Ospitalieri di Cremona, Italy Funding: MEDEA, Medicina e Arte, Onlus, Cremona Disclosure: All authors have declared no conflicts of interest

Background: During COVID pandemic, many cancer patients (pts) refused to come to hospital, suspending therapies, with ominous consequences. Based on positive (+) results of DOMONCOVID, our homecare project for COVID+ cancer pts, we created a new model of assistance, ONCOHOME, delivering cancer care at home to immune-compromised pts. We aim to provide data on feasibility, efficacy and costs of this innovative model. Methods: ONCOHOME is a multicenter project involving 3 Cancer Center (CC) of the North of Italy: National Cancer Institute, San Raffaele in Milan and Cremona CC. We created an organizational homecare model based on a medical and nursing team with a car equipped for home visits and a secretariat managing patient calls, with a dedicated phone number. The team administers cancer care at home and provides pts with the same assistance usually delivered in hospital. Patient-reported outcome (PRO) assessment is performed. Results: From August 3rd 2020 to May 5th 2021, 79 cancer pts were assisted at home by Cremona team, receiving oral (62 pts), subcutaneous (10pts) or intravenous therapy (7 pts). All types of cancer were included. 77% of pts had a metastatic disease, 88% had a PS ECOG 0-1. Median duration of assistance was 126 days [range 2-270 days]. Most of the pts received oral chemotherapy (41pts). TKIs (25 pts), hormonal therapy (12 pts), supportive care with denosumab and zolendronic acid (5 pts ) and immunotherapy (1 patient, pt) were successfully administered at home, too. 13 pts required hospitalization due to clinical complications. In this group, only 2 pts were admitted to hospital due to severe toxicity;in particular, 1 pt treated with trifluridin/tipiracil developed febrile neutropenia and 1 pt treated with gefitinib reported Grade 3 diarrhea. Both pts were discharged and continued to be assisted at home. Conclusions: ONCOHOME showed that inpatient or outpatient cancer drug administration could be successfully replaced by home administration, for appropriate therapies and selected pts. This model is feasible at an affordable cost. The project is ongoing, planning to accrue other 100 pts for each center. ONCOHOME will be implemented with electronic devices for PRO evaluation, certified telemedicine service and non-invasive wearable smart tissue monitoring physiological parameters devices. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Background: Cancer patients (pts) have higher risk of serious COVID-19 symptoms, morbidity and mortality than general population. SARS-CoV-2 vaccine trials excluded patients with metastatic cancer or undergoing immunosuppressive therapies;therefore, the effectiveness of vaccines are unknown in this population. Hence, there is an urgent need to understand the correlation between cancer type, its treatment and vaccine efficacy. Trial design: Methods: This is a prospective study conducted by the Oncology Unit of Cremona (Cr) Hospital, enrolling pts from Oncology, Hematology, Radiotherapy (RT) and Palliative Care divisions. The trial aims to evaluate effectiveness of mRNA vaccines [BNT162b2 (Pfizer) and mRNA-1273 (Moderna)], incidence of symptomatic COVID-19 infection, antibodies (Abs) response and onset of adverse events (AEs) in a consecutive population of 300 cancer pts, undergoing antiblastic therapies, starting from March 2021. A vaccination point was set up by Cr Hospital, dedicated to cancer pts treated with chemotherapy (CT), TKIs, RT, hormones. Only pts in follow-up or treated with adjuvant hormone are excluded. CT was suspended at least 5 days before and 3 days after vaccination;targeted therapy, immunotherapy and RT are not interrupted. Primary endpoint: Number of symptomatic pts affected by COVID-19, diagnosed 7-60 days after the 2nddose of vaccines. The infection is defined according to the FDA criteria combined with a positive nasopharyngeal swab. Secondary endpoints: Abs variation at different timepoints compared to baseline;vaccine-related adverse events;duration of abs, up to 12 months after 2nd dose;correlation between effectiveness of vaccines and antiblastic treatments, tumor burden, PS ECOG. Statistical analysis: The primary objective will be tested by non-inferiority one-single proportion test, compared with the value of 95% observed in the vaccine registration trials. The hypothesis of vaccine inferiority in the trial population is rejected if a rate of protection conferred by the vaccine is observed in 89% of the sample size. Results Preliminary results will be available in July 2021. Clinical trial identification: NCT04878796. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

This study examines the development and feasibility of a quality improvement strategy for the translation of evidence-based psychosocial care into clinical practice. The project involved all staff (oncologists, psychologists, and nurses) of the participating centers. Recommendations concerned: improvement of clinician communication skills; use of a patient question prompt list; assignment of a specialist nurse to each patient; screening for psychological distress and social needs; opportunity to attend a Point of Information and Support. The implementation strategy hinged on context analysis and problem solving. Four to six visits were held in each center by the project team to assist staff in identifying obstacles, finding solutions, and strengthening motivation. The primary variable was the adherence percentage to the recommendations (proportion of subjects receiving each intervention). The number of centers that failed to reach the objective was also reported (adherence percentage

Background Incorporating psychosocial research into practice is challenging. Aim of this study is to assess the feasibility in real life of interventions which have been tested in RCTs and have demonstrated to improve pts psychosocial conditions. Methods This is an implementation study of five EBM interventions, conducted in 28 centers. We adopted the model of Pronovost [BMJ 2008], which includes: context analysis to identify local barriers, introduction of the interventions, and evaluation of how many pts receive the recommended interventions. Primary EPs: degree of implementation detected in a blinded fashion by external trained personnel. EBM interventions included: 1) communication courses for doctors and nurses [Ann Oncol 2011]; 2) use of a question prompt list (QPL) [Cancer 2008]; 3) creation of the Point of Information and Support (PIS) in the ward [J Clin Oncol 2009]; 4) identification of a referring nurse (RN) for informing and educating pts [J Clin Nurs 2010]; 5) screening of distress and social needs [J Natl Compr Canc Netw 2010]. Results 33 centers applied to partecipate, 29 were eligible and 28 are evaluable. Final blinded analisys was conducted on 305 consecutive patients. 156 oncologists and 401 nurses attended the 3 days training course. An Australian QPL was subjected to cross-cultural adaptation, yielding the first validated Italian QPL [BMC Health Serv Res 2010]. 25 centers (89%) have successfully implemented the majority of interventions; 1 is too early and 3 centers failed for various reasons: internal conflicts of the staff, poor motivation, etc. Main results for each intervention are shown in the table: Table: 1462PD EBM TRAINING COURSES (No and % of attendee, oncologists plus nurses) REFERRING NURSE (RN) (No and % of pts with a RN) PIS (No and % of Units with a PIS) USE OF THE QPL (No and % of pts who receive the QPL) PSYCHO-SOCIAL EVALUATION (No and % of screened patients) Pre-Implementation 0/598 (0%) 0% 4/29 (17%) 0% 0% Post-Implementation 557/598 (93%) 262/305 (86%) 24/29 (83%) 223/305 (73%) 253/305 (83%) Conclusions Using this methodology, a successful implementation of EBM measures is possible in the vast majority of centers and yields significant improvement in the delivery of psychosocial care. Funded by the Italian Ministry of Health and the Lombardia Region Disclosure All authors have declared no conflicts of interest.

9120 Background: Incorporating psychosocial research into practice is challenging. Aim of this study is to assess the feasibility and effectiveness in real life of interventions which have been tested in RCTs and have demonstrated to improve pts psychosocial conditions Methods: This is an implementation study of five EBM interventions conducted in 28 centers. We adopted the model of Pronovost (BMJ 2008), which includes context analysis to identify local barriers; introduction of the interventions, and evaluation of how many pts receive the recommended interventions. Primary EPs: degree of implementation detected in a blinded fashion by external personnel. Interventions included: 1) EBM communication courses for doctors and nurses; 2) use of a question prompt list (QPL) for all pts; 3) creation of the Point of Information and Support (PIS) in the ward (J Clin Oncol 27:1794-99,2009); 4) identification of a referring nurse (RN) for informing and educating pts; 5) screening of distress and social needs. Results: In December 2008, 28 eligible centers applied to participate. 27 are evaluable and 1 is too early. 156 oncologists and 401 nurses attended the 3 days training course. A QPL was subjected to cross-cultural adaptation, yielding the first validated Italian QPL (BMC Health Serv Res 2010). 24 centers (89%) have successfully implemented the intervention; 3 centers failed for various reasons: internal conflicts of the staff, poor motivation, etc. Main results for each intervention are shown in the table. Conclusions: A successful implementation of EBM measure was obtained in the vast majority of oncology centers and yields to significant changes in the delivery of psychosocial care. Project funded by the Italian Ministry of Health and Lombardia Region. [Table: see text]