below 40% in hospital (Fig. 1). Moreover, at least for hematology patients, ICU survivors achieve remission and good quality of life as much as non-ICU patients [7, 8]. (3) Most classic predictors of mortality have lost much of their value [9]. (4) Noninvasive diagnostic and therapeutic strategies have allowed new clinical approaches for high-risk cancer patients [10]. These strategies have advocated early admission to the ICU, avoiding risky procedures, and offering earlier monitoring. (5) Finally, because triage criteria for ICU admission have shown poor reliability, new strategies of ICU admission have been offered to cancer patients. Improvement in survival of critically ill patients with cancer. a Intensive care unit (ICU) survival, b hospital survival, and c 1-year survival are illustrated. The results shown are from publications that reported the survival of critically ill patients with cancer who required ICU admission. Each dot represents the mean survival reported in one study, and the color of the dots represents the patient population. Green studies reported the survival of patients with hematologic malignancies (HM), blue studies reported the survival of patients with solid tumors (ST), and red studies reported the survival of mixed populations, including patients with HM and patients with ST This group of authors includes experts in the management of critically ill cancer patients who have recently published on this topic. The literature review searched most relevant articles appearing in PUBMED since the year 2000. Earlier publications may have been quoted because they are used as landmark contributions to the field or as reference prior to major changes. In this review, we highlight recent changes in the use and the results of intensive care in patients with malignancies. In addition to describing the standard of care for the management of cancer patients, a research agenda includes important studies to be conducted in the next few years to increase our understanding of organ dysfunction in this population and to improve our ability to appropriately use life-saving therapies or select new therapeutic approaches that are likely to improve outcomes. Current standard of care for critical care delivery to patients with malignancies We all believe that it is mandatory to harmonize the level of care provided to cancer patients across countries, institutions, and ICUs . The following elements of the standard of care have been developed in recent years and merit attention. Avoiding delayed admission to the ICU Initial reluctance to admit cancer patients to the ICU leads to repeated discussions, conflicts, and delayed ICU admission [14]. Bed availability is also an issue in some settings [15], and ICU treatments can be delivered outside the ICU [16]. However, admission to the ICU shortly after the start of the critical care illness is associated with better survival rates [8]. In patients with acute respiratory failure, both oxygen requirement at presentation and time between hospital and ICU admission have been shown to be associated with mortality [17]. Likewise, direct admission to the ICU leads to decreased mortality in patients with hyperleukocytic acute myeloid leukemia (AML) who are at high risk of tumor lysis syndrome and leukostasis but have no organ dysfunction at presentation [18]. Moreover, early detection of the physical changes that announce the onset of critical illness plays an important role in alerting clinicians that the time for ICU admission may have come