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Background: SARS-CoV-2 outbreak has impacted on the management of oncological p, leading to treatment delays in a considerable number of cases The aim of this study was to evaluate if oncological T affected negatively COVID-19 outcome Methods: We retrospectively analyzed clinical data from p with solid tumors under active systemic T (received in the last 6 months) that were diagnosed with SARS-CoV-2 infection (defined as positive PCR) between March and 11th May 2020 in our center Study endpoint was death due to COVID-19 We divided the patients in two groups;those who had received treatment in the last 4 weeks and those who had not Descriptive and univariate analysis were performed to detect the effect of T type and other variables on COVID-19 related mortality Results: A total of 70 p were included with a median follow-up of 28 days (10-47) and active oncological T had been administered in the past 4 weeks to 44 p Median age was 66 (IQR 56-74), 23 p (52 27%) were female and 41 (93 2%) had a baseline ECOG≤1 The most frequent primary site was lung tumor (12 p [27 3%]), followed by breast (11 p [25%]) and gastrointestinal (5 p [11 4%]) Thirty-one p (70 5%) had metastatic disease and 13 (29 5%) were included in clinical trials Twenty-four p (54 5%) received chemotherapy (CT), 14 (31 8%) targeted therapies, 9 (20 4%) immunotherapy (IT), 5 (11 4%) radiotherapy and 6 (13 6%) hormonotherapy A total of 13 p (29 5%) received different combinations of oncological T Death due to COVID-19 occurred in 5/22 (22 7%) p receiving CT and 6/21 (28 5%) p in the non-CT (p>0 05) Only 1/9 (11 1%) p treated with IT died compared to 11/35 (31 4%) p in the rest of the cohort (p>0 05) Age>71, comorbidities such as chronic obstructive pulmonary disease and ECOG status>2 were associated to a higher mortality The distribution of these variables between the anticancer T groups was not different Conclusions: Our results suggest that CT and other anticancer T might not worsen COVID-19 related mortality;nevertheless, the number of patients was small and decision making has to be individualized Our findings may warrant further investigation in larger studies Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: E Felip: Advisory/Consultancy, Speaker Bureau/Expert testimony: AbbVie;AstraZeneca;Blueprint medicines;Boehringer Ingelheim;Bristol-Myers Squibb;Celgene;Eli Lilly;Guardant Health;Janssen;Medscape;Merck KGaA;Novartis;Pfizer;Roche;Takeda;Touchtime;Research grant/Funding (self), Research grant/Funding (institution): Fundacion Merck Salud;Oncology Innovation EMD Serono J Carles: Advisory/Consultancy, Speaker Bureau/Expert testimony: Johnson & Johnson;Bayer;Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Astellas Pharma;Advisory/Consultancy: Pfizer;Sanofi;MSD Oncology;Advisory/Consultancy, Research grant/Funding (self): Roche;Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: AstraZeneca;Speaker Bureau/Expert testimony: Asofarma;Research grant/Funding (self), Travel/Accommodation/Expenses: BMS;ravel/Accommodation/Expenses: Ipsen;Roche;Research grant/Funding (self): AB Science;Aragon Pharmaceuticals;Pharmaceuticals;INC;Blueprint Medicines Corporation;N Immunotherapeutics INC;Boehringer Ingelheim Espana, S A ;Clovis Oncology;Cougar Biotechnology INC;Deciphera Pharmaceuticals LLC;Exelixis INC;F Hoffmann-La Roche LTD;Genentech INC;Glaxosmithkline;Incyte Corporation;Janssen-Cilag International NV;Karyopharm Therapeutics INC;Laboratoires Leurquin Mediolanum SAS J Tabernero: Honoraria (self): Array Biopharma;AstraZeneca;Bayer;BeiGene;Boehringer Ingelheim;Chugai;Genentech;Genmab A/S;Halozyme;Imugene Limited;Inflection Biosciences Limited;Ipsen;Kura Oncology;Lilly;MSD;Merck Serono;Menarini;Merrimack;Merus;Molecular Partners;Novartis;Peptomyc;Pfizer;Pharmacyclics;ProteoDesign SL;Rafael Pharmaceuticals;F Hoffmann-La Roche Ltd;): Sanofi;eaGen;Seattle Genetics, Servier, Symphogen, Taiho, VCN Biosciences, Biocartis, Foundation Medicine, HalioDX SAS and Roche Diagnostics All other authors have declared no conflicts of interest

Background Nutritional status affects survival of pts with HNC. Close to half HNC pts require enteral nutrition, with percutaneous endoscopic gastrostomy (PEG) being the preferred route. We studied whether PEG placement technique and timing impact on HNC pts outcomes. Methods We retrospectively analyzed all HNC pts who underwent PEG insertion between February 2014 and August 2018 at Vall d´Hebron University Hospital. The primary objectives were to assess overall survival (OS) and PEG complication rate in light of nutritional parameters (albumin, cholesterol and PCR) and disease stage (local and locally-advanced [LA] vs recurrent-metastatic [R/M]) when PEG is placed in a prophylactic (P-PEG) or symptomatic (S-PEG) setting with endoscopic or radiologic intervention. Results Out of 125 pts, 52% had LA disease and 48% R/M, 37% had P-PEG, 63% S-PEG [tumor related symptoms (61%), treatment toxicity (30%), nasogastric tube intolerance or dysfunction (6%), and other feeding disorders (3%)]. High albumin and cholesterol levels associated with better of OS [HR = 0.64 (CI 95% 0.42-0.98), p = 0.04 and HR = 0.65 (CI 95% 0.43-0.99), p = 0.04, respectively]. In the R/M setting, no difference in median OS was observed between P-PEG 18.9 months (m) (CI 95% 12.7-45) and S-PEG 15.6 m (CI 95% 11.5-22.2, HR = 0.89, CI 95% 0.57-1.4, p = 0.62). In the LA setting, we found numerically longer median OS in pts with P-PEG 42.2 m (CI 95% 21.9-NA) vs PEG-S 16.2 m (CI 95% 11.5-NA, HR = 0.72, CI 95% 0.37-1.94, p = 0.33). Complication rate was 28% in the P-PEG group vs 30% S-PEG group (p = 0.8). Most common complications included infection 35%, ileus and delayed gastric emptying (22%), and bronchial aspiration (13%). Complications led to treatment interruption in 4 pts (3.2%). Complication rate was lower in LA setting than in R/M setting (24% vs 35%, p = 0.2). Endoscopic PEG placement was associated with less complications (9%) than radiologic placement (47%, p = 0.08). Conclusions We confirmed that nutritional parameters impact on HNC pts OS. In the LA setting, P-PEG might be associated with a better outcome. Endoscopic PEG placement appears to be related to fewer complications. Our results will help design a PEG placement algorithm to further evaluate the role of P-PEG. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure J. Tabernero: Advisory / Consultancy: Arrays Biopharma; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bayer; Advisory / Consultancy: BeiGene; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Chugai; Advisory / Consultancy: Genentech; Advisory / Consultancy: Inc; Advisory / Consultancy: Genmab A/S; Advisory / Consultancy: Halozyme; Advisory / Consultancy: Imugene Limited; Advisory / Consultancy: Inflection Biosciences Limited; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Kura Oncology; Advisory / Consultancy: Lilly; Advisory / Consultancy: MSD; Advisory / Consultancy: Menarini; Advisory / Consultancy: Merrimack; Advisory / Consultancy: Merus; Advisory / Consultancy: Molecular Partners, Novartis, Peptomyc, Pfizer, Pharmacyclics, ProteoDesign SL, Rafael Pharmaceuticals, F. Hoffmann-La Roche Ltd, Sanofi, SeaGen, Seattle Genetics, Servier, Symphogen, Taiho, VCN Biosciences, Biocartis, Foundation Medicine, HalioDX SAS. E. Felip: Advisory / Consultancy: AbbVie, AstraZeneca, Blue Print Medicines, Boehringer Ingelheim, BMS, Celgene, Eli Lilly, Guardant Health, Merck KGaA, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Takeda, Janssen; Speaker Bureau / Expert testimony: AbbVie, AstraZeneca, Boehringer Ingelheim, BMS, Eli Lilly, Merck KGaA, Merck sharp & dohme, Novartis, Pfizer, Roche, Takeda.; Research grant / Funding (self): Fundacion Merck Salud Grant for Oncology Innovation. R. Dienstmann: Advisory / Consultancy: Roche ; Speaker Bureau / Expert testimony: Roche, Symphogen, Ipsen, Amgen, Sanofi, MSD, Servier; Research grant / Funding (self): Merck. All other authors have declared no conflicts of interest.