nasopharyngeal aspirates, blood, urine, or imaging tests) without FOB-BAL may be safe and effective in most patients [10]. Compared to FOB-BAL, noninvasive tests have the same diagnostic and therapeutic yields. However, 15% of the patients still require FOB-BAL, chiefly those with suspected Pneumocystis pneumonia, with drug-related pulmonary toxicity, or who present possible drug-related pulmonary toxicity. We advocate that expert discussion should be performed prior to any diagnostic tests, as the clinical relevance of the results relies on the pretest probability of every single potential diagnosis. Notably, some vignettes can only be made using BAL (alveolar hemorrhage, alveolar proteinosis, etc.). Finally, we recommend that patients undergoing lung biopsy for diagnostic purposes first undergo FOB-BAL. A personal approach tailored to every patient according to the underlying disease, ongoing prophylaxes and treatments, as well as local facilities to perform all possible noninvasive tests or to secure and optimize FOB-BAL are required. ICU triage and admission policies Obviously, every medical decision must emphasize justice (a chance for all according to what is available) and autonomy (values and preferences of patients). We know that decision-making with regard to ICU admission is imprecise and that this is a source of increased mortality owing to delayed ICU admission, as well as a source of nonbeneficial care [101, 102]. In cancer patients, all these elements are valid and even translate into higher attributable mortality [103]. In a single-center study, one in four patients considered by the ICU team to be too sick to benefit from ICU admission actually survived, while one in five patients considered too well to benefit actually died [103]. In addition, we cannot rely on severity of illness scores to guide a decision at the level of the individual patient. As our ability to identify cancer patients likely to benefit from ICU management is limited, new strategies of ICU admission have been developed and validated (Fig. 2) [95, 104,105,106]. Time-limited trials [95, 105] have been one of the major changes with regard to ICU admission of cancer patients since the turn of the century. The strategy consists in unlimited ICU management with a full-code status for a limited period. Patients and relatives are important partners in all decisions. The time of full-code status seems to be at least 2 weeks in hematology patients, unless they are in multiple organ failure, in which case 1 week would be enough to provide the same survival as with unlimited aggressive care [95, 105]. In patients with solid tumors, a week of ICU trial should be enough, and in the case of multiple organ failure, a full-code management for 4–5 days leads to similar outcomes as unlimited aggressive care [95, 105]. The impact of identified targets for biotherapy is not known [107]. Other strategies of ICU admission include prophylactic ICU admission in patients at high risk for tumoral compression, lysis syndrome, leukemic infiltrates, etc. These new strategies of ICU admission have been widely accepted for patients with hematological malignancies and are recommended in guidelines published by the British Committee for Standards in Hematology and in French guidelines [67, 108]. Importantly, in settings where bed availability is limited, early aggressive treatment can be initiated outside the ICU [16]. Collaboration between hematologists/oncologists and intensivists Care of critically ill patients with cancer is complex