pneumonitis, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pleural effusion, and pulmonary hypertension The diagnosis remains one of exclusion, and rechallenge should be discouraged. Early cessation of the drug is the best treatment. Corticosteroids may be useful. Monoclonal antibodies provoke a wide variety of systemic and cutaneous adverse events, including the full range of true pulmonary, cardiac, liver, or renal hypersensitivities, which can be fatal. We encourage the critical care community to open a registry of critically ill cancer patients admitted to the ICU for treatment of the side effects of targeted therapy and biotherapy. Also, improving intensivists’ skills to recognize and diagnose these side effects could be one of the secondary outcomes of interventions enhancing dialogue between oncologists/hematologists and intensivists on a daily basis. Lastly, as tumor lysis syndrome will be increasingly encountered in patients with solid tumors receiving immunotherapy, clinicians need to be aware and prepared. Transfusion policies As mentioned above, it would be desirable to establish the indications for early RBC transfusion as part of initial resuscitation from severe sepsis in cancer patients, in whom hemoglobin is frequently chronically reduced. Also, besides mortality, the optimal transfusion threshold in the case of persistent tissue dysoxia and altered lactate clearance has to be established [60, 61]. Last, studies to clarify indications and thresholds for platelet transfusions in cancer patients with thrombocytopenia are warranted. Moving back from noninvasive to invasive management At the end of the 1990s, noninvasive diagnostic and therapeutic management were believed to be the best ways to avoid worsening the patient’s status and increasing mortality [32]. Indeed, mortality of patients intubated was as high as 90%, making NIV a life-saving intervention [32]. Also, severe hypoxemia, thrombocytopenia, and hemostatic disorders have discouraged invasive diagnostic strategies such as BAL and lung, liver, or kidney biopsies, placing biomarkers and molecular biology techniques at the forefront of noninvasive diagnostic tests. However, the mortality associated with intubation has decreased substantially amid increasing evidence that hypoxemic patients with tachypnea have a high respiratory drive and may inflict ventilator-induced lung injury on their lungs [41]. Moreover, the use of NIV or HFNC has made FOB-BAL safer, and CT-guided minimally invasive biopsies have a high diagnostic yield with a relatively low frequency of side effects [143]. We recommend again evaluation of invasive versus noninvasive diagnostic and therapeutic strategies. Also, noninvasive diagnostic tests should be compared to minimally invasive biopsies. Studies are needed to better document whether delayed intubation related to trial of NIV, CPAP using a facial device or a helmet, or HFNC actually increases mortality. Here, careful continuous and precise monitoring of expiratory tidal volumes under NIV should be performed and its relation to mortality reassessed. Rescue strategies for cancer patients with ARDS Corticosteroids have been tested in patients with leukemic infiltrates, Pneumocystis pneumonia, diffuse alveolar hemorrhage, or acute interstitial pneumonia without documented infection, but the level of evidence remains weak [144]. The improvement in oxygenation should be balanced against the increased rate of secondary