medical oncology department - fondazione irccs · medical oncology 1 filippo de braud ... benedetta...

scientific report 2012

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scientific report 2012scientific report 2012

DIRECTOR OF DEPARTMENT Filippo de Braud +39 02 [email protected]

UNITSMedical Oncology 1Filippo de Braud

Medical Oncology 2alessandro M. Gianni

Adult Sarcoma Medical Treatmentpaolo G. Casali

Head And Neck Cancer Medical Oncologylisa liCitra

Medical Day HospitalroBerto Buzzoni

Respiratory PathophysiologyroBerto BoFFi

Cardiologypatrizia piotti

Clinical PsychologyClaudia Borreani

MEDICAL ONCOLOGY DEPARTMENT

the Medical oncology department provides for comprehensive cancer treatments in adults with solid tumors and performs research focusing on new drug development and treatment strategies. overall, 187 studies were ongoing in 2012 ranging from phase i to an antismoking campaign. the department maximizes opportunities for inter-departmental and inter-institutional collaborations to ensure it is at the forefront of patient care and oncology research. the Medical oncology department comprises various clinical medical units (with 46 inpatient beds), one centralized day hospital (with 23 outpatient beds for day hospital treatments and MaC procedures, and 11 medical chairs); outpatients visits are performed in 14 dedicated rooms.the department is organized in the following units:Medical Oncology 1: gastrointestinal and lung tumors, melanoma, renal and prostate cancers and breast carcinomas; treatment and development of new drugs Medical Oncology 2: preclinical and clinical activities mainly for malignant lymphomas and germ cell tumorsMedical Day Hospital: deals with adult patients referred by the clinical units of the department, as well as diagnosis, treatment and follow-up of neuroendocrine tumors Adult Sarcoma Medical Treatment: clinical research activities in sarcomas and peritoneal mesothelioma Head and Neck Cancer Medical Oncology: clinical activity in head and neck carcinomas Cardiology (see shared research resources, page 116)Respiratory Pathophysiology (see shared research resources, page 117)Clinical Psychology (see shared research resources, page 118)

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Medical Oncology Department

HEADFilippo de Braud, Md

CLINICAL RESEARCH STAFF Giulia V. Bianchi, Md, Giuseppe Capri, Md, luigi Celio, Md, sara Cresta, Md, Michele del Vecchio, Md, Maria di Bartolomeo, Md,Marina Garassino, Md, Gabriella Mariani, Md, angela Moliterni, Md, Marco platania, Md, Giuseppe procopio, Md, elena Verzoni, Md, nicoletta zilembo, Md

POSTDOCTORAL FELLOWSValentina Colonna, Md, silvia damian, Md, elena de Benedictis, Md, lorenza di Guardo, Md, Fiorella dotti K., Md, Francesco Gelsomino, Md, paolo Grassi, Md, eva r. Haspinger, Md, paola Mariani, Md,Filippo pietrantonio, Md, lorenzo pilla, Md,sara pusceddu, Md, danila serpico, Md, Vitali Milena, Md

RESEARCH STAFF Benedetta Bardazza and alessandra Castano (research nurses)antonia Martinetti, Biol sci d elisa sottotetti, Biol sci d

RESIDENTS Francesco agustoni, Md, pamela Biondani, Md, Matteo duca, Md, arpine Gevorgyan, Md, Claudia Maggi, Md, Monica niger, Md, Francesca ricchini, Md, lorenzo sica, Md, anna tessari, Md, isabella testa, Md

ADMINISTRATIVE PERSONNEL Barbara Formisano, Giuseppa iannaci, sabrina lanterna, susanna Maggi

DATA MANAGERS Valentina sinno, dsc (coordinator), ilaria Bossi, dsc d, rosaria Gallucci, dsc, alessandra siliprandi, irene Vetrano, dsc

our mission is to improve clinical care and outcomes of medical treatment of cancer through multidisciplinary management, personalized medicine, and the development of new drugs and strategies. a major effort has been made to reshape the infrastructure for inpatient care and renew the clinical research structure. Major areas of interest include: • Adjuvant and systemic treatments of breast cancer: the identification

and selection of different subsets of breast cancer patients who will be treated differently, according to the molecular profile of their disease (i.e. integrating targeted therapies with standard chemotherapy or with hormone treatment).

• New drug development (phase i and ib studies) and the promotion of translational research projects. an entire unit was fully dedicated to developing treatments using new molecular compounds and to investigate new therapeutic strategies for all solid tumors.

• Translational research on prognostic and/or predictive biomarkers in most solid tumors (upper and lower gastrointestinal tract, non-small cell lung cancer, malignant pleural mesothelioma, and thymoma).

• New generation targeted therapy and immunotherapy for malignant melanoma.

• Adjuvant and systemic treatment of patients affected by renal cell carcinoma and the management of castration-resistant prostate cancer using new therapeutic approaches.

• Active involvement in research on antiemetic drugs. the facilities available at the Medical oncology department include a 22-bed inpatient ward, a day hospital area, 9 consulting rooms (one of which is dedicated to consultations and first admittance visits), and a research laboratory for pharmacokinetic and pharmacodynamic evaluation of new treatments. in 2012, the unit carried out 36,079 clinical visits and 5036 consultations to new patients. Forty-six trials were activated, six of which were phase i, during the 2012 and overall 125 are the ongoing studies.Keywords: patient care, new drug development, personalized medicine

MeDicAL oncoLoGY 1

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our institute is renowned for groundbreaking treatments in lymphoma, and our group works to find novel therapeutic possibilities. Medical oncology 2 unit carries out both preclinical and clinical translational research in a variety of fields, including cellular therapy with hematopoietic stem cells, autologous stem cell transplantation (asCt), targeted therapies, and immunotherapy. our mission is to improve the quality of care mainly for patients with non-Hodgkin lymphoma (nHl), Hodgkin lymphoma (Hl), multiple myeloma, and testicular and bladder cancers. this is pursued by a translational

approach in which innovative strategies and targeted drugs are tested in a preclinical setting and then used in a clinical setting. in addition, by designing clinical trials and participating in them, we gain access to new treatments when they are not yet widely available to other hospitals.

the major areas of interest are as follows. • translational research on poor prognosis relapsed/refractory lymphoma

patients by: a) development of new chemotherapy approaches and combinations of chemotherapeutics; b) study of oncogenic cooperation between signaling molecules in malignant cells to determine the rationale for their combinatorial inhibition with specific drugs; c) use of novel anti-lymphoma monoclonal antibodies, alone or in association with chemotherapy; d) preclinical studies to identify novel antigens that are candidates for new pharmacological targets.

• epidemiologic studies aimed at the identification of predictive factors for the onset of side effects in long-term survivors after chemo-radiotherapy to design tailored therapy.

• development of targeted therapeutics and translational trials in urothelial, germ-cell, and penile cancers.

the facilities available at Medical oncology 2 include: a 12-bed inpatient ward, a day-hospital area, 4 consulting rooms, and a laboratory for translational preclinical research. in 2012, the unit managed a total of 500 admissions resulting in 150 inpatient treatments; 32 patients received asCt for lymphoma, high-risk selected sarcoma and germ cell tumors. a total of 1500 treatments were administered in day hospital; 7500 clinical visits and 600 consultations to patients at first access were performed. thirty-two trials were active in 2012. the unit is certified by uni en iso9001:2000, Joint Commission international and JaCie standard for the transplant activity.Keywords: lymphoma, testicular cancer, targeted therapies, high-dose chemotherapy,

immunotherapy

HEADalessandro M. Gianni, Md

CLINICAL RESEARCH STAFFliliana F. devizzi, Md

Massimo a. di nicola, Mdanna Guidetti, Md

Michele Magni, Mdpaola Matteucci, Mdandrea necchi, Md

simonetta Viviani, Md

RESEARCH STAFFalessandra Canavè, phd

Giusi ruggero, Fellow roberta zappasodi, phd

POSTDOCTORAL FELLOWpatrizia Giannatempo, Md

RESIDENTS luca Bergamaschi, Mdannamaria Marte, Mdemanuela paternò, Md

NURSESlucia saracino (coordinator), stefania

Bevacqua, Matteo Biondelli, rita Boffa, salvatore Capuano, letizia de palma, elisea Ferrante, Veronica Fuccio, santina Marafioti,

Giovanna Miceli, immacolata navarra, Chiara paternoster, Giuseppina tomassini,

daniela trentin

HEALTHCARE ASSISTANTSantonietta M. Maglione, agnese lasala,

loredana Costa, Mauro l. pedretti, antonella di perna

ADMINISTRATIVE PERSONNEL Maria luisa longhi

MeDicAL oncoLoGY 2

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the adult Mesenchymal tumor Medical oncology unit treats adult patients with mesenchymal neoplasms and peritoneal mesothelioma. it operates within the institutional multidisciplinary sarcoma tumor Board. the unit has always kept a strong focus on networking. it coordinates the italian network on rare Cancers (rtr), a project aimed at sharing cases of adult patients with rare solid cancers to improve the quality of care and reduce patient migration. in addition, it coordinates the rare cancer area of the lombardy regional Cancer network (rol). the unit was involved in driving the update of the esMo Clinical Guidelines on soft tissue sarcomas, gastrointestinal stromal tumors (Gist), and bone sarcomas. it also coordinated the working group developing clinical practice guidelines on sarcomas and rare tumors within the lombardy regional Cancer network. in addition to institutional research projects, clinical research activities included the participation in national and international prospective clinical studies on sarcomas, within the italian sarcoma Group (isG) and the soft tissue and Bone sarcoma Group of the eortC. overall, in 2012 the unit participated in 29 clinical studies, with 85 patients enrolled. Major areas of research interest were:• Translational research on prognostic and/or predictive biomarkers in

soft tissue sarcomas, Gist, rare bone tumors (chordoma, giant cell tumor), and malignant peritoneal mesothelioma

• Targeted therapy for soft tissue sarcomas, Gist, and rare bone tumors (chordoma, giant cell tumor)

• Histology-driven medical therapy of soft tissue sarcomas.other major areas of interest include the general aspects of rare cancers care, with regards to health organization issues and methodology of clinical research. the unit was involved in the rareCare project, whose aim was to provide a “list” of rare cancers, with incidence, prevalence, and survival data in europe. Currently the unit has joined the rareCarenet project (“information network on rare cancers”), whose aim is to disseminate data about health care facilities, information resources, and clinical practice guidelines on rare cancers across europe. in addition, the unit submitted a european project aimed at the development of guidelines on new methodologies for clinical research on rare cancers. Finally, the unit regularly collaborates with patient advocacy groups in italy and europe in the field of rare cancers, sarcomas, and Gist.institutional facilities include a 6-bed inpatient ward, a day hospital area, 3 consulting rooms (one of which is dedicated to consultations and first visits). in 2012, the unit carried out more than 5000 outpatient visits (more than 700 on new sarcoma patients), while about 700 new sarcoma patients were treated in collaboration with other italian centers within the italian network on rare Cancers (rtr). Keywords: adult sarcoma, GIST, rare cancers

HEADpaolo G. Casali, Md

CLINICAL RESEARCH STAFFrossella M. Bertulli, Md elena r. Fumagalli, Md Michela libertini, Mdandrea Marrari, Mdelena palassini, Md Giovanna r. sanfilippo, Mdsilvia stacchiotti, Md

RESIDENTVittoria Colia, Md

ADMINISTRATIVE PERSONNELstefania Cimbari, anabela di Giovanni, paola esposti, elisabetta prati

DATA MANAGERSCamilla Cassani (coordinator), Federica Favales

ADULt MesencHYMAL tUMor MeDicAL oncoLoGY

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HEADlisa licitra, Md

CLINICAL RESEARCH STAFFCristiana Bergamini, Md

paolo Bossi, Md roberta Granata, Md

laura locati, Md aurora Mirabile, Md

RESIDENTCarlo resteghini, Md

ADMINISTRATIVE PERSONNEL and data Managers are shared with adult

Mesenchymal tumor Medical oncology

the unit performed the following clinical activities in 2012: 489 inpatient admissions, 281 day hospital admissions, and 2311 outpatient visits. as regards our clinical research activities, in 2012 eleven studies were started, 102 patients enrolled, and specifically:• nine trials on thyroid cancer• 10 trials on squamous head and neck cancer• one trial each on salivary gland tumors and on advanced basal cell

carcinomathe unit was also involved in the establishment of the lombardy regional Cancer network (rol) for head and neck cancers.Keywords: head and neck cancer, medical oncology, clinical research

HeAD AnD necK cAncer MeDicAL oncoLoGY

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the day Hospital and oncologic outpatient therapy unit (MdH) treats adult patients referred by both the Medical oncology and the Hematology departments. the complexity of some oncologic medical treatments and the increasing number of medical trials frequently require close observation during treatment and one day hospitalization. treatments are prepared by specialized nurses who dilute therapeutic agents in a protected area equipped with two air flow cabinets, and administer them under the supervision of MdH physicians. a separate section is dedicated to short duration regimens or biological therapies by infusion pump systems and management of central venous catheters. special care is given to management and prevention of emesis, diarrhea, extravasation of cytotoxic drugs, and acute drug reactions for which a project about pharmacovigilance (FarMaonCo) is ongoing. since 2009, the referent physician of this regional project is dr. Ferrari. acute adverse effects are reported, with the help of dr. Fanetti, in a regional database, and then merged with information from other regions to form a national database. to date, 333 adverse reactions have been reported.a room in the outpatient clinic is dedicated to diagnosis, treatment, and follow-up in patients diagnosed with neuroendocrine tumors (net) and a database with all net cases followed in our institution is ongoing with the collaboration of dr. damato. int has been certified as a Center of excellence by the european society neuroendocrine tumors (enet). a biweekly tumor Board, attended by surgery, endoscopy, radiotherapy, cardiology and medical experts, discusses the most complex cases. these activities are carried out along with Medical oncology 1.in 2012, the activity of MdH consisted of 21,609 procedures (monthly average activity of 1800) subdivided as follows: 10,965 short therapies (carried out in the outpatient area); 2174 CVC medications; 7364 long therapies; 965 dH (treatments or procedures requiring admission); 141 MaC (since 04/2012). the cancer types treated included breast cancer (31.3%), gastrointestinal cancer (20.7%), hematologic malignancies (20.9%), melanoma (5.3%), lung cancer (8.3%), head and neck cancer (6.4%), sarcoma (3.1%), and other tumors (4%).Keywords: antineoplastic administration; pharmacovigilance project; neuroendocrine tumors

HEADroberto Buzzoni, Md

CLINICAL RESEARCH STAFFlaura a.M. Ferrari, Md

CLINICAL FELLOWSGiuseppe Fanetti, Mdangela damato, Md

ADMINISTRATIVE PERSONNELanna r. Cabiddu, antonella Bifano

NURSESdeborah zordan (coordinator), Chiara Bernasconi, domenica Comberiati, lucia d’agnessa, laura di Vico, Claudia Facchinetti, anna Frisario, lucia Giordano, Francesca Maffione, elena nuti, Maria paolillo, Maria n. pisanu, stefania russo, elena sala, laura sala, sonia sanapo, pietrina sanna

HEALTHCARE ASSISTANTSVincenzina arnone, Fabio di Bartolo, lucia a. di Murro, Maria rosa Forte, anna Maria Meloni, rita trovato

MeDicAL DAY HospitAL

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Hematology and Pediatric Onco-Hematology Department

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medical oncology department - fondazione irccs · medical oncology 1 filippo de braud ... benedetta...

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