The rare southern Australian rhodophyte, previously known as Ptilota (?) hannafordii Harvey 1862, is morpho-anatomically re-examined and the new genus Sgouracanthus and tribe Sgouracantheae are proposed to accommodate it. Thalli of Sgouracanthus hannafordii may reach 38 cm in length and grow individually in the sublittoral zone (to 33 m depth) attached to rock and macroalgae, although most records are from drift specimens bearing debris and grit among its curly and spiny branches. Sgouracanthus exhibits whorl-branches of determinate growth bearing procarps on their basal cells, which characterizes basal members of Ceramioideae, but the new genus is here classified in the Wrangeliaceae on account of oblique apical divisions, dense cortication, lack of gland cells, elongate spermatangial heads, polysporangia, a distinctive fusion cell, and multinucleate vegetative cells. In addition, Sgouracanthus develops a single auxiliary cell and tetrahedrally divided subspherical tetrasporangia, characters found in members of both groups. The taxonomic analysis supports a position near Spongoclonium and Dasythamniella, which is in agreement with a gene phylogeny based on the nuclear small subunit rDNA.

A phylogenetic analysis shows the Mesophyllaceae comprise the subfamilies Clathromorphoideae Athanas. et D. L. Ballant. subfam. nov., Protomesophylloideae Athanas. et D. L. Ballant. subfam. nov., and Mesophylloideae Athanas. et D. L. Ballant. subfam. nov., the last one including the main core of species previously assigned to Mesophyllum and Leptophytum. The Clathromorphoideae comprise the genera Clathromorphum, Neopolyporolithon, Callilithophytum, and the monotypic Clathmoroa Athanas. et D. L. Ballant. gen. nov. based on C. tubiformis (Y. M. Chamb., R. E. Norris, et G. W. Maneveldt) Athanas. et D. L. Ballant. comb. nov. from South Africa. Protomesophylloideae is monotypic, based on Protomesophyllum ameleteton Athanas. et D. L. Ballant. sp. nov. from southern Australia, New Zealand, and the Chatham Islands. The Mesophylloideae comprise the tribes Amphithallieae Athanas. et D. L. Ballant. trib. nov., Melyvonneeae Athanas. et D. L. Ballant. trib. nov., and Magnephyceae Athanas. et D. L. Ballant. trib. nov. Amphithallieae include the genera Amphithallia, Synarthrophyton, Carlskottsbergia, Capensia, and the monotypic Kerguelena Athanas. et D. L. Ballant. gen. nov. (type: K. dickiei Athanas. et D. L. Ballant. comb. et nom. nov.) and Masoniana Athanas. et D. L. Ballant. gen. nov. (type: M. kraftii Athanas. et D. L. Ballant. comb. et nom. nov. from southern Australia). Melyvonneeae include the genera Phragmope, Mesophyllum, Melyvonnea, Perithallis, Thallis, Sunesonia, Printziana (comprising the type and P. insignis (Foslie) Athanas. et D. L. Ballant. comb. nov. from New Zealand), and the new monotypic Macroblastum Athanas. et D. L. Ballant. gen. nov. based on the Mediterranean M. dendrospermum Athanas. et D. L. Ballant. comb. et nom. nov.Magnephyceae include the genera Kvaleya, Leptophytum, Leptothallia Athanas. et D. L. Ballant. gen. nov. (based on L. acervata (Foslie) Athanas. et D. L. Ballant. comb. nov. from South Africa), Macedonis Athanas. et D. L. Ballant. gen. nov. (including the Aegean generitype M. tethygenis Athanas. et D. L. Ballant. comb. et nom. nov. and the NE Pacific M. julieae (Athanas. et W. H. Adey) Athanas. et D. L. Ballant. comb. nov., M. lamellicola (Athanas. et W. H. Adey) Athanas. et D. L. Ballant. comb. nov., and M. kymatodis (Athanas.) Athanas. et D. L. Ballant. comb. nov.), Hyperandri Athanas. et D. L. Ballant. gen. nov. (including the generitype from Pacific Mexico H. dawsonii Athanas. et D. L. Ballant. comb. et nom. nov., the Canarian-Caribbean H. bisporum (Foslie) Athanas. et D. L. Ballant. comb. nov., and the Thai H.siamense (Foslie) Athanas. et D. L. Ballant., comb. nov.), the monotypic Ectocarpa Athanas. et D. L. Ballant. gen. nov. (based on E. capverdensis Athanas. et D. L. Ballant., comb. et nom. nov.), Magnephycus Athanas. et D. L. Ballant. gen. nov. (including the Caribbean generitype M. ornatus (Foslie et M. Howe) Athanas. et D. L. Ballant. comb. nov., the southern Australian M. engelhartii (Foslie) Athanas. et D. L. Ballant. comb. nov., and the Indo-Pacific M. simulans (Foslie) Athanas. et D. L. Ballant. comb. nov.), Mastophoropsis, and Phymatolithopsis (the last genus being incertae sedis). As outgroups are selected two genera of Melobesiaceae: Melobesia (Melobesioideae) and Orthocarpa Athanas. et D. L. Ballant. gen. nov. (type: O. epicklonia Athanas. et D. L. Ballant. sp. nov. from southern Australia, placed in Orthocarpoideae Athanas. et D. L. Ballant. subfam. nov.). They share production of a fusion cell/gonimoblast just below the carpogonia and development of both lateral and orthostichous carposporangia, whereas the Mesophyllaceae develop carposporangia mainly laterally and produce a fusion cell/gonimoblast at the level of supporting cells. A further character distinguishing the Mesophyllaceae is the development of a cell tube, a prerequisite to transfer the zygote beyond the hypogynous cell to the subtending supporting (auxiliary) cell. Orthocarpa also accommodates several species previously placed in Synarthrophyton: Orthocarpa eckloniae (Foslie) Athanas. et D. L. Ballant. comb. nov., O. haptericola (Foslie) Athanas. et D. L. Ballant. comb. nov. (=Synarthrophyton schielianum), O. magellanica (Foslie) Athanas. et D. L. Ballant. comb. nov., O. papillata (G. W. Maneveldt, D. W. Keats, et Y. M. Chamb.) Athanas. et D. L. Ballant. comb. nov., O. munimenta (D. W. Keats et G. W. Maneveldt) Athanas. et D. L. Ballant. comb. nov., O. robbenensis (D. W. Keats et G. W. Maneveldt) Athanas. et D. L. Ballant. comb. nov., O. pseudospora A. S. Harv., Woelk., et A. Millar) Athanas. et D. L. Ballant. comb. nov., and O. chejuensis (J. Kim, H. Chung, D. Choi, et I. Lee) Athanas. et D. L. Ballant. comb. nov. The new family Lithothamnionaceae Athanas. et D. L. Ballant. nom. nov. (=“Lithothamniaceae H. J. Hees 1886” nom. illeg.) and the new combination Titanoderma chamberlainianum (Woelk. et S. T. Cambell) Athanas. et D. L. Ballant. comb. nov. (=Lithophyllum chamberlainianum) are proposed. A key to Mesophyllaceae subfamilies, tribes, and genera is presented.

Thromboembolism is a well-recognized complication of malignant disease. There are reciprocal links between cancer and thrombosis.The incidence of lung cancer ranks high among cancers worldwide which leads to the largest number of absolute events of lung cancer associated thrombosis (LCAT). Thrombosis incidence can even be up to 20% in lung cancer (LC) patients, based on epidemiological investigations and LCAT is usually associated with a poor prognosis which increases morbidity, mortality, and medical costs.

6637 Background: Venous Thromboembolisms (VTEs) lead to many negative consequences for patients with active cancer and are reported up to 20%. They affect anticancer treatment plan, increase morbidity, mortality, economic burden, and escalate psychological drain. Current guidelines recommend pharmacologic prophylaxis for thrombosis in ambulatory cancer patients with Khorana score ≥2. Methods: GMaT and ACT4CAT are prospective observational phase IV studies conducted by HeSMO in Greece. The aim was to record the clinical practice for ambulatory patients with active cancer who received thromboprophylaxis and enrolled after signing informed consent. Studies were approved by the bioethics committee. Results: 1157 patients from 26 oncology clinics enrolled who received thromboprophylaxis. Tumor types: gastrointestinal 38.5%, lung 24.8%, urological 12.2%, gynecological 6.9%, breast 6.1% and others 11.5%. Treatment lines: 1st 62.5%, 2nd 15.1%, 3rd 4%, adjuvant 9.7% and neoadjuvant 5.9%. Age ≥65 in 55.2%, BMI ≥30 in 17.8% and males 59.9%. High-Risk for Thrombosis Agents (HRTAs) received 82.3%: platinum agents (52.9%), antimetabolites (49.0%) and immunotherapy (10.2%). Notably, 52.7% of anticancer agents had potential drug-drug interactions (DDIs) with Direct Oral Anticoagulants (DOACs). High thrombotic risk factors presented in table. Thromboprophylaxis duration was 5.1±3.3 months with: tinzaparin 91.2%, fondaparinux 4.6%, bemiparin 2.3%, enoxaparin 1.2%, rivaroxaban 0.4% and apixaban 0.3%. Intermediate thromboprophylaxis doses of Low Molecular Weight Heparins (LMWHs) received 62% of patients; 50% in adjuvant setting & 72.6% in metastatic. 32 thrombotic events reported (efficacy: 97.2%, 95%CI: 96.3-98.2%) and 26 grade 1 or minor bleedings (2.2%, 95%CI:1.4-3.1%). Patients receiving intermediate doses of LMWHs had less risk for thrombosis (p=0.0308). Conclusions: VTEs prophylaxis in ambulatory patients with active cancer was found safe and effective. Apart from Khorana score, metastasis, HRTAs and DDIs seem to affect clinical decision for thromboprophylaxis mainly with LMWHs and often using intermediate doses irrelevant of clinical setting. Cancer Associated Thrombosis (CAT) is not negligible risk for patients and oncologists appeared to be aware about this. Clinical trial information: NCT03292107 , NCT03909399 . [Table: see text]

The thrombotic risk, up to 9 times higher in cancer patients than in general population, has increased over recent years, might due to increased survival of cancer patients, novel cancer therapies, & increased diagnostic modalities. Most of the thrombotic events observed shortly before & after cancer diagnosis. Thomboprophylaxis in oncology patients remains a challenge. HeSMO conducted 2 prospective observational studies (GMaT & ACT4CT) aiming to record thromboprophylaxis daily clinical practice in ambulatory patients with active cancer. Patients enrolled after signing informed consent. 1117 patients from 26 oncology centers recruited (age: 65.2±12.2 years, BMI: 26.1±5.2 Kg/m2, 59.7% males). 74.3% had metastasis, 82.6% treated with Highly Thrombogenic Agents (HTAs), such as platinum (53.3%), antimetabolites (50.0%), immunotherapy (10.0%) and 21% with radiotherapy. 52.8% of HTAs had potential drug-drug interactions (DDIs) with Direct Oral Anticoagulants. 61.5% & 15.7% of patients were at 1st & 2nd line respectively & 9.7%, 6.2% in adjuvant & neoadjuvant setting. 58.5% had Khorana score ≥2. Details depicted in table. Anticoagulation agents include (in%): 91.9 tinzaparin, 4.5 fondaparinux, 2.1 bemiparin, 1.1 enoxaparin, 0.2 rivaroxaban & apixaban, for 5.2±3.2 months duration. 61.3% of patients received intermediate dose (1st, 2nd, adjuvant & neoadjuvant: 61.4%, 67.3%, 43.0% & 71.4% respectively). 30 patients (2.7%) had thrombotic events, related to: thrombosis history (OR: 4.6, p=0.0030), radiotherapy (OR: 2.6, p=0.0092), prophylactic dose (OR: 2.8, p=0.0049). 18 minor bleeding events reported (1.6%).Table: 1585PCancerTreatmentPatientBiomarkerPrimary SiteIncidence (%)Females (%)Metastatic (%)HTAs (%)Radiotherapy (%)Age ≥65Comorbidities (%)Khorana score ≥2Lung25.521.782.783.134.356.746.163Pancreatic22.142.275.897.13.355.335.8100Colorectal9.641.180.888.81658.952.319.6Stomach7.628.673.491.610.760.747.6100Breast5.998.468.856.145.237.960.610.6Ovarian5.510066.1851.75950.859Bladder4.822.57084.918.971.754.745.3Prostate3.7-95.14034.285.465.917.1Testicular2-14.3100-4.613.636.4Head & neck1.43063.68073.333.353.3-Uterine0.710083.387.512.562.52562.5Cervical0.51008010020-2080Others10.945.660.561.728.660.352.126.5 Open table in a new tab High thrombotic burden neoplasms, metastatic disease, HTAs, potential DDIs, influence doctors' decision for anticoagulation apart from Khorana score. Thromboprophylaxis in high risk patients with active cancer endures during anti-neoplasmatic treatment and seem both effective and safe.

Thromboprophylaxis, as a preventive measure for cancer-associated thrombosis (CAT), may be beneficial for patients with active cancer and high-risk for thrombosis. The present post hoc analysis include a total of 407 patients enrolled in the Greek Management of Thrombosis study, who received thromboprophylaxis with tinzaparin. The objectives of the present analysis were: i) To obtain sufficient evidence for the administration of prophylaxis in patients with active cancer, irrespective of Khorana risk assessment model score; ii) to identify the selection criteria for both dose and duration of tinzaparin; and iii) to evaluate the efficacy and safety of tinzaparin administered for CAT prophylaxis. The main tumor types for the patients included in the present study were as follows: Lung (25.1%), pancreatic (14.3%), breast (9.1%), stomach (8.4%), colorectal (7.9%) and ovarian (7.6%). Furthermore, metastatic disease was observed in 69.5% of the patients. High thrombotic burden agents (HTBAs) were administered to 66.3% of the patients, and 17.4% received erythropoietin. A total of 43.7% of the patients exhibited a Khorana score <2. The results of the present study demonstrated that both the presence of metastatic disease and the use of HTBAs seemed to influence oncologists' decisions for the use of thromboprophylaxis in patients with active cancer, regardless of Khorana score. Tinzaparin, in dose expressed in the standard notation for heparins, i.e., anti-Xa factor international units (Anti-Xa IU), was administered at an intermediate dose (InterD; 8,000-12,000 Anti-Xa IU; once daily) to 52.4% of patients, while the remaining patients received a prophylactic dose (ProD; ≤4,500 Anti-Xa IU; once daily). The average duration of thromoprophylaxis was 5 months. Furthermore, a total of 14 (3.4%) thrombotic events and 6 (1.5%) minor bleeding events were recorded. A total of four thrombotic events were observed following an InterD treatment of tinzaparin, while 10 thrombotic events were observed following ProD treatment. The present study also demonstrated that an InterD of tinzaparin was administered more frequently to patients with a body mass index >30 kg/m2, a history of smoking and a history of metastatic disease, along with administration of erythropoietin. InterD tinzaparin treatment was found to be potentially more efficacious and without safety concerns. The present study is a registered clinical trial (ClinicalTrials.gov code, NCT03292107; registration date, September 25, 2017).

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Malignancies can exaggerate thrombosis risk up to 20%. For Lung Cancer (LC) up to 14% [Lung Cancer Associated Thrombosis-LCAT). Moreover, thrombosis amplifies the LC progression, i.e. thrombosis-associated lung cancer (TALC). LCAT & TALC have multifactorial pathophysiology, depending on LC characteristics, specific anti-cancer management, patient characteristics, and biomarkers such as tissue factor, neutrophil extracellular traps, cancer procoagulant, and cytokines.

e18677 Background: Venous ThromboEmbolism (VTE), might be a challenge with a lot of negative consequences for patients with active cancer. VTE affects ongoing anticancer treatment, worsening morbidity and mortality, increases economic burden and escalates psychological distress. Incidence of VTE in patients with cancer reported 20%. Current guidelines recommend pharmacologic prophylaxis in ambulatory cancer patients with Khorana score ≥2. Methods: ACT4CAT is a prospective observational phase IV study conducted by HeSMO Greece, aiming to record the clinical practice of VTE prophylaxis in active cancer patients. Ambulatory patients who received thromboprophylaxis enrolled after signing informed consent. Study was approved by bioethics committee. Results: 691 patients from 19 oncology departments received thromboprophylaxis in 1 st line 57.6%, 2nd line 14.8%, adjuvant 9.0% and neoadjuvant 7.5%. Age ≥65 found 55%, BMI≥30 17.5% and males 63%. Tumor types: gastrointestinal 45.4%, lung 25.8%, urological 11.6%, gynecological 6.0%, breast 4.2% and others 7.0%. High-Risk for Thrombosis Agents (HRTAs) received 87.2%, specifically: platinum agents (56.3%), antimetabolites (54.2%) and immunotherapy (12.1%). 54,5% of the anticancer agents had potential drug-drug interaction (DDI) with anticoagulation treatment. Thromboprophylaxis duration lasted 5.3±3.5 months. Main agents were: tinzaparin 89.6%, fondaparinux 6.0%, bemiparin 2.2%, enoxaparin 1.6%, apixaban 0.3% and rivaroxaban 0.3%. Intermediate thromboprophylaxis dose received 68% of patients, lower in adjuvant setting (45.2%), with a preference in metastatic cases (OR: 1.5 95% CI: 1.02-2.3, p = 0.026). 14 thrombotic events reported (efficacy: 98.0%, 95%CI: 96.6-98.8%) and 12 grade 1 bleeding (1.7%, 95%CI: 1.0-3.0%). Conclusions: Prevention of VTE in ambulatory patients with active cancer found effective and safe. Apart from the Khorana score, specific patient characteristics, metastasis, HRTAs and DDIs seemed that affect clinical decision for thromboprophylaxis mainly with LMWHs and often on intermediate dose regardless the clinical setting. Oncologists appeared informed that CAT is not negligible risk. Clinical trial information: NCT03909399. [Table: see text]

Background/Aim: This study aimed to provide real-world safety and effectiveness data of everolimus (EVE) plus exemestane (EXE) in estrogen receptor positive/human epidermal growth factor receptor 2 negative (ER+/HER2–) advanced breast cancer (aBC). Patients and Methods: This prospective observational study was conducted by 19 hospital-based oncologists in Greece. Eligible patients were treated with EVE+EXE in the first-line setting; EVE was initiated according to the approved label. Results: Overall, 75 eligible patients (mean age: 66.9 years; visceral metastases: 49.3%; bone-only metastases: 37.3%) were included in the effectiveness analyses. Over a median (interquartile range) of 12.1 months (range=4.2-20.5 months) of EVE treatment, the median progression-free survival was 18.0 months and the overall response rate was 22.7%. Among patients that received ≥1 EVE dose (n=80), the incidence of EVE-related adverse events was 72.5% (serious: 55.0%); stomatitis (22.5%), fatigue (22.5%), pneumonitis (18.8%); and cough (18.8%) were the most common. Conclusion: In the routine care in Greece, EVE demonstrates clinical benefit and a predictable safety profile.

The structure of canals in multiporate conceptacles of Mesophyllaceae is analysed and several distinct types are recognized. In what appears to be the plesiomorphic condition, canals are straight and bordered by non-differentiated pore cells. In the majority of Mesophyllaceae, pore cells are thinner-wider, starting from basal cells and extending towards the apical opening. This can be coupled with development of triangular (conical) or pyriform canals. Other modifications occur at species or genus level, or across several genera, the most distinctive being formation of cell bars (Phragmope discrepans), elongate basal cells (Melyvonnea), or branched pore filaments composed of fewer cells than adjacent roof filaments and provided with elongate subbasal (or basal and subbasal) cells (Thallis-Perithallis, respectively Printziana-Sunesonia). In Thallis-Perithallis-Sunesonia-Melyvonnea, pore filaments are composed of fewer cells than adjacent roof filaments and terminate below the roof surface. It is postulated that the elongate basal cells in Melyvonnea resulted after loss of basally branched pore cells, an evolutionary step that finds justification in the new genus Sunesonia where homologous cells become reduced or deteriorated. A new thallus organization (aniso-bilateral) characterized by a diminutive ventral perithallium distinguishes Perithallis. Nine new taxa are described, including accounts of their historical record, typifications, comparison of their types to new collections, and the published molecular work that provides further support: Thallis capensis gen. & sp. nov., Perithallis incisa gen. et comb. nov., P. chathamensis (Foslie) nov. comb., Printziana australis gen. & nom. nov. and Sunesonia pseuderubescens gen. et sp. nov.

e18803 Background: Cancer Associated Thrombosis (CAT) is an increasing challenge for oncology patients since oncologists sometimes are reluctant to mitigate the risk with thromboprophylaxis. Active cancer patients while receiving chemotherapy have a 7fold risk of thrombosis compared with no cancer patients. Anticoagulation holds a prominent place in prevention of CAT usually with Low Molecular Weight Heparins (LMWHs). Methods: ACT4CAT is prospective observational study conducted by HeSMO across Greece, aiming to record the clinical practice of CAT prophylaxis in patients with solid tumors. Ambulatory, high thrombotic risk, active cancer patients who received thromboprophylaxis enrolled after signing informed consent. Results: Preliminary results collected from 18 oncology departments. From 431 enrolled patients 322 (65.4%) had completed the study. Tumor types included: lung 28.8%, gastrointestinal 39.8%, gynecological 7.0%, breast 4.4%, urological 7.0% and others 20%. Majority of patients (88.2%) received High-Risk for Thrombosis Chemotherapy Agents (HRTCAs) such as platinum agents (55.9%), antimetabolites (44.7%) and immunotherapy (12.6%). In 1 st line were 62.1%, 2nd line 18.4%, adjuvant 8.9% and neoadjuvant 2.4%. The following table depicts: age, gender, metastatic disease, Khorana score ≥2 and HRTCAs. All patients received thromboprophylaxis for 5.3±3.6 months with: tinzaparin 90.8%, fondaparinux 5.5%, bemiparin 1.5%, enoxaparin 1.2%, apixaban 0.5% and rivaroxaban 0.5%. Intermediate doses received 70.9% of patients regardless clinical setting (1 st , 2 nd , adjuvant & neoadjuvant: 70.2%, 79.2%, 51.3% and 70.0% respectively, p = 0.0254), although intermediate doses were used more in metastatic stages (OR:2.4 95%CI: 1.4-4.2, p = 0.0028). Nine thrombotic events reported (2.1%, 95%CI: 1.1-3.9%), irrespective of clinical setting but with a trend towards prophylactic doses. Eleven grade 1 bleedings reported (2.6%, 95%CI: 1.4-4.5%), despite clinical setting or dose used. Conclusions: Thromboprophylaxis in ambulatory active cancer patients with high thrombotic risk is safe and effective. Oncologists are alerted about CAT negative influences in cancer patients’ prognosis. Apart from Khorana score, factors such as metastases, use of HRTCAs and drug-drug interactions influence the clinical decision of thromboprophylaxis in active cancer patients mainly with LMWHs and quite often with intermediate doses regardless clinical setting. Clinical trial information: NCT03909399. [Table: see text]

e14135 Background: CAT is the 2nd leading cause of death in oncology patients and there is need for thrombosis management across the natural history of cancer because of its dynamic nature. Anticoagulant therapy is the cornerstone of prevention and treatment, since thrombosis interferes with cancer treatment, increases health care resource utilization, imposes emotional and economic burden. Methods: A prospective observational study conducted by HeSMO across Greece, aiming to record the clinical practice of CAT prophylaxis in patients with solid tumors. Ambulatory, high risk for thrombosis, active cancer patients who received thromboprophylaxis are enrolled after signing informed consent. Results: Preliminary results are collected from 17 oncology departments. From the 272 enrolled patients, 176 (64.7%) have completed second visit (3-4 cycles of anticancer treatment). Primary cancers included: lung 31.3%, pancreas 26.1%, colorectal 13.6%, gynecological cancers 10.2%, stomach 7.8%, bladder 6.3%, and others.75.6% of the patients had metastatic disease. 1/3 of the patients were smokers or ex-smokers, and 33% underwent surgery. Most of patients (65.9%) were at 1st line treatment and 17.6% at 2nd line. The vast majority (90.3%) were treated with High-Risk for Thrombosis Chemotherapy Agents (HRTCAs) such as cisplatin etc. Regarding Khorana score, 65.1% had ≥2. In particular, 86.7% of patients with Khorana score ≤1 received HRTCAs while 95.4% of patients with score = 2.All patients received thromboprophylaxis, specifically: 93.0% tinzaparin, 5.2% fondaparinux and 1.8% other (enoxaparin, bemiparin) with average duration 5.3±3.1 months. 67.1% of the patients received higher than standard prophylactic doses. 3 patients (1.7%) experienced thrombotic events (2 DVT and 1 PE). These 3 patients had metastases and were treated with HRTCAs. Five grade 1 bleeding events were reported (2.8%). Conclusions: Thromboprophylaxis of CAT is both safe and effective. Oncologists are alerted about CAT negative influences in cancer patients’ prognosis. Apart from Khorana score, factors such as metastases, use of HRTCAs along with drug-drug interactions, increase the LMWHs usage often in higher than prophylactic doses in CAT management. Clinical trial information: NCT03909399.

CAT is common cause of death and many complications in cancer patients. There is a need for thrombosis management across the natural history of cancer due to its dynamic nature. Anticoagulant therapy is the cornerstone of CAT prevention and treatment. A prospective, observational study conducted by HeSMO across Greece, aiming to record the clinical practice of CAT prophylaxis in solid tumors. Ambulatory active cancer patients, receiving thromboprophylaxis for highly thrombotic tumors, are enrolled after signing informed consent. Preliminary results from 17 oncology departments are presented. From 272 enrolled patients, 260 (95.6%, mean age: 66 years, mean weight: 75 Kg.) have completed the second visit. Tumor types included: lung 31.5%, pancreas 19.7%, colorectal 11.6%, gynecological cancers 8.5%, stomach 7.7%, bladder 6.2%, etc. 76.8% of patients had metastatic disease. Most patients (62.6%) were at 1st line treatment. Vast majority (87.8%) were treated with High-Risk for Thrombosis Chemotherapy Agents (HRTCAs). Regarding Khorana score, 75% had score ≤2. All patients were receiving anticoagulation agents as thromboprophylaxis (92.7% tinzaparin, 5.4% fondaparinux, etc) with average duration 5.7±3.5 months. 69% received higher than standard prophylactic dose. Higher thromboprophylaxis doses were administered more frequently in metastatic disease 75% compared to 56% in non-metastatic setting (OR: 2.4, 95% CI: 1.1-5.1, p=0.02). Moreover, higher doses were administered in patients receiving erythropoietin (OR: 2.4, 95% CI: 1-6.1). Three patients (1.2%) experienced thrombotic events and five minor bleeding events (1.9%). Oncologists are alerted about CAT negative influence in cancer patients' prognosis. In active cancer ambulatory patients, factors contributing to thrombotic burden such as high thrombotic risk tumor type, metastases, use of HRTCAs along with drug-drug interactions, apart from Khorana score, are considered as decisive factors to apply thromboprophylaxis. Effective doses under the duration of anti-neoplasmatic treatment are both safe and efficient.

NeuroEndocrine Neoplasms (NENs) are rare tumors and can grow in almost all tissues. Regardlesshistological, molecular and imaging characteristicsthat are indicative of the primary origin, significant percentage remains of unknown primary. A prospective observational study was conducted by HeSMO in Oncology Departments to register patients with histologically confirmed NEN. Inclusion criteria were: a) residencyin Greece, b) treatment by medical Oncologist in Greece, c) Age > 14 years and d) signed informed consent. 223 patients (pts) diagnosed with NENs were enrolled of 7 centers from 1/2012to 2/2020.The female to maleratio (104/119) was 1.1 and the age range was 19-89 years (ys). The higher incidence concerned the age range 60-69 ys (27.8% 62 pts), followed by 70-79 ys (21.97% 49 pts) and 50-59 ys (21.5% 48 pts). The most frequently primary sites were lung (26.9% 60 pts), pancreas (15.69% 35 pts) and stomach (12.1% 27 pts). Less frequent were ileum/small intestine (5.38% 12 pts), cecum (4.93% 11 pts), colon (3.58% 8 pts), duodenum (2.24% 4 pts) and rectum (1.79% 3 pts). Less common primary sites were in 15.24% (34 pts) whereas in12.10% (27 pts) they were unknown primary tumors. The distribution of stages at diagnosis, were early stage in 20%, locally advanced in 48% and metastatic in 32%pts. Results regarding histology and treatments will be presented as well. These are preliminary results from the largest prospective NEN registries in Greece. Due to the increased training of NEN specialists in pathologyand the improved imaging methods, NENs are increasingly recognized. However, a large percentage of pts are diagnosed in locally advanced or metastatic stages. It is necessaryto improve the rates of early diagnosis and identification of NENs.

Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the second leading cause of death in these patients but it can be preventable with thromboprophylaxis. Patients and Methods: An observational, prospective, multicenter study aiming to record CAT management in clinical practice was conducted by the Hellenic Society of Medical Oncology (HeSMO). Results: A total of 426 active cancer patients (mean age 65.3 years, mean BMI: 26.1 kg/m2) who received thromboprophylaxis, were included from 18 oncology units. Tumor types were lung 25.1%, pancreas 13.9%, breast 8.7%, stomach 8.5%, ovarian 7.8%, and others 36%, while 69% had metastases. A total of 71% had a Khorana score ≤2 and 61% received High Thrombotic Risk Chemotherapy Agents (HTRCAs, e.g., platinum). For thromboprophylaxis patients received mainly Low Molecular Weight Heparins (LMWHs), on higher than prophylactic doses in 50% of cases. Overall, 16 (3.8%) thrombotic events and 6 (1.4%) bleeding events were recorded. Notably, patients on higher doses of LMWHs compared to patients who received standard prophylactic doses had 70% lower odds to develop thrombotic events (OR: 0.3, 95% CI: 0.10–1.0, p = 0.04). Conclusion: CAT is an important issue in oncology. Along with the Khorana score, factors as metastases and use of HTRCAs should also be taken into consideration. Thromboprophylaxis for active cancer patients with LMWHs, even on higher doses is safe and efficient.

The original material of Lithophyllum hibernicum Foslie was re-examined and two different species, unequally represented in the collection were found: most thalli belong to a sterile species of Lithophyllum, represented in the protologue by elements related to cell size and coaxial arrangement. A few sterile thalli belong to Lithothamnion cf. corallioides, and this species is also represented in the protologue by a single statement of branch size. Yet, the species of Lithophyllum is the sole representative in Foslie's unpublished materials included in the type collection in TRH. A previous lectotypification, contradicting Art. 9.14 (that demands the type to correspond to its original description rather than to a certain taxonomic concept), is sustained because it preserves Foslie's intent. The lectotype of L. hibernicum is a sterile, branched rhodolith with characteristic cup- or funnel-shaped formations on its thallus. Syntypes are inhabited by an endo-, epiphytic species of Gelidiales forming openings resembling conceptacle ostioles. Molecular comparison with topotypes is needed before synonymy with the common epilithic species Lithophyllum bathyporum in the NE Atlantic should be accepted.