improved. As a consequence, some concepts should be revised. Cancer-related characteristics are no longer associated with short-term mortality For decades, the diagnosis of malignancy per se and complications from underlying disease or its treatment drove decisions to offer critical care to cancer patients. Over the past 20 years, we have learned that the nature and the staging of the underlying malignancy are no longer associated with mortality after an ICU stay [9, 11, 70, 72]. Indeed, for cancer patients selected by oncologists/hematologists, disease-related characteristics do not affect outcomes. Also, the impact of the underlying disease is erased by mechanical ventilation, vasopressors, or RRT. With the increasing use of time-limited trials, however, patients will be selected chiefly on the basis of their performance status, but also their ability to receive high-dose therapy, challenging the impact of cancer characteristics on outcome [8, 94, 95]. Finally, at a time when targeted therapy and biotherapies are widely used in cancer patients, it is likely that an increased number of patients with advanced disease will be admitted to the ICU, warranting a reappraisal of classic predictors of mortality [3]. Performance status is a constant predictor of mortality Performance status (PS) is a simple and widely used scale to assess function and guide treatment in patients with cancer. It is a key outcome predictor in all critically ill patients [8, 9, 11, 70, 96]. Altered PS may be related to the burden of age and comorbidities, or to the aggressiveness of the disease. Whatever the reason why PS is altered, studies have shown that poor PS translates into increased mortality, with case fatality reaching 85–90% in patients who are bedridden or dependent [8, 9, 11, 70, 96Neutropenia is probably not a predictor of high mortality Until the early years of this century, neutropenia was considered to be associated with very high mortality in the critically ill, leading to the common belief that life-saving therapies were futile in these patients. However, advances in the management of specific complications in patients with neutropenia, the diagnosis and management of infections, and the routine use of prophylactic antibiotics and antifungals based on updated recommendations have been substantial [9, 45, 67, 97]. We do not recommend including neutropenia as a driver for admitting or not admitting a patient to the ICU. Similarly, we do not recommend that neutropenia be taken into account in deciding to withhold or withdraw life-sustaining therapies [98]. In this setting, studies to confirm safety and feasibility, and also the potential individual or collective benefits of de-escalation in patients with neutropenia, are warranted [99]. Not every patient with acute respiratory failure and pulmonary infiltrates should undergo fiberoptic bronchoscopy and bronchoalveolar lavage (FOB-BAL) Hypoxemic acute respiratory failure with pulmonary infiltrates is one of the major life-threatening complications in patients with hematological malignancies. Management of these patients is complex, and failure to identify the cause of ARF is associated with poor outcomes [26, 42]. FOB-BAL was considered as the cornerstone of the diagnostic strategy in this setting. However, respiratory deterioration and the need for intubation following BAL have been reported [100]. Mandatory FOB-BAL was challenged by a multicenter randomized trial, the results of which suggested that an initial noninvasive diagnostic strategy (based on sputa,