ESMO  Translational  Unit  Visit    

Fondazione  IRCCS  Istituto  Nazionale  dei  Tumori    Milano,  Italy  

 13  –  16th  May  2014  

 Topic:  ‘Integrating  multidisciplinary  issues  in  clinical  oncology:  the  paradigm  of  urologic  tumours’  

 

The  Fondazione   IRCCS   Istituto  Nazionale   dei   Tumori   of  Milan   (INT)   is   the   largest  comprehensive  cancer  centre   in   Italy.   Since   its   establishment,   in   1928,   this   public   institution   has   aimed   to   provide   the   highest  standard  of  patient  care  while  pursuing  preclinical  and  clinical  research  and  its  swift  translation  into  better  prevention,  diagnosis,  therapy,  rehabilitation,  and  quality  of  life.    INT   is   an   institute   for   scientific   research,   treatment   and   care,   research   at   INT   is   funded   by   the  National  Ministry  of  Health  and  is  supported  by  the  regional  authorities  for  its  role  in  regional  healthcare.  Moreover,  research  is  also  substantially  funded  by  numerous  other  bodies,  both  public  -­‐  such  as  the  European  Union  and  the  Ministry  of  University  and  Research   (MIUR)   -­‐  and  private,   in  particular   the   Italian  Association   for  Cancer  Research  (AIRC).  Finally,  an  extremely  large  number  of  Italian  tax  payers  choose  to  assign  their  0.5%  income  tax  contribution  to  this  Institution.    The   Fondazione   IRCCS   Istituto   Nazionale   dei   Tumori   is   a   comprehensive   cancer   centre   whose   activities  range   from   epidemiology   (both   descriptive   and  molecular)   to   rehabilitation   and   palliative   care,   through  innovative  prevention,  diagnosis  and  treatment.  Being   a   centre   of   research   and   care   in   accordance   with   its   institutional   mission,   INT   is   in   a   privileged  position  to  conduct  translational  research.  To  this  end,  large,  multidisciplinary  groups,  including  both  basic  

                                                                                                     

scientists   and   clinicians,   and   also   bio-­‐informaticians   and   statisticians,   work   together   to   plan   major  multidisciplinary  research  projects.    As   a   comprehensive   cancer   centre   for   excellence,   INT   is   deeply   committed   to   quality   education   and  training.      Educational   activities   are   available   for   clinical   and   experimental   researchers   at   different   stages   of   their  education   and   training.   Postdoctoral   research   fellowships,   graduate   student   training,   medical   residency  training,   psychology   and   social   work   training,   as   well   as   many   opportunities   for   continuing   medical  education  are  part  of  the  wide  ranging  academic  options  available  at  INT.    As   regards   research   activities,   various   flexible,   multidisciplinary   groups   have   been   set   up   according   to  research  objectives  which,  on   the  one  hand,   are  part  of   a   Strategic  Program,  and  on   the  other  originate  from  the  specific  scientific  need  of  each  Department.  The  Development  of  New  Therapies  in  Medical  Oncology  is  focused  on  testing  new  drugs  for  the  treatment  of     various   solid   tumours,   such  as  breast,   head  &  neck,  urothelial   and  gynecologic   cancers.   The  Prostate  Program   involves   a  wide   range  of   scientists   and   clinicians   in   a  program   that   combines   clinical   trials  with  extensive   experimental   research.   The   Lung  Program   studies   new  ways   for   early   detection  of   the  disease  with   proteomic   blood   analysis,   but   also   cancer   stem   cells,   tumour  progression,   and   apoptosis   regulation  and   targetable   cells,  whereas   the   Breast   Program   concentrates   on   gene   expression   profiling   and   on   the  study   of   cancer   initiating   cells.   The  Melanoma   research   group,   in   collaboration  with   the   Immunobiology  Units,   studies   human   melanoma   interaction   with   the   microenvironment   in   order   to   characterize   pro-­‐inflammatory  and  immunosuppressive  programs  activated  in  these  tumours.    At   the   preclinical   level,   the   research   programs   of   The   Hereditary   Tumours   group   are   focused   on   the  identification  of  genetic  markers,  and  on  the  development  of  in  vitro  and  in  vivo  assays  for  the  classification  of   allelic   variants   in   known   cancer   susceptibility   genes.   Current   research   in   the   Experimental   Oncology  Department   includes   investigations   on  molecular   and   cellular   determinants   and  mechanisms   of   tumour  onset,   growth   and   progression.   There   is   also   research   into   inherited   factors   underlying   genetic  susceptibility   to   cancer,   in  both  humans  and  experimental  mouse  models.  More   therapeutically  oriented  studies  are  aimed  at  developing  and  selecting  new  analogues  of  conventional  drugs,  as  well  as  new  target-­‐specific   agents,   and   optimizing   their   use   in   different   experimental   models.   Studies   identifying   growth  signals   and   checkpoint   functions   that   are   essential   for   the   proliferation   and   survival   of   cancer   cells   are  being  used   to   identify   and   validate  predictors  of   tumour  progression   and   treatment   response.   They   also  help  define  new  targets  for  drug  therapy  and  novel  therapeutic  approaches  to  modulate  cellular  response  to   drugs   currently   used   as   chemo   preventive   and/or   anticancer   agents.   The   relationship   between   the  immune   system,   tissue   undergoing   transformation   and   tumour   progression   is   also   studied.   Therapeutic  studies   also   include   basic,   translational   and   clinical   analyses   of   the   different   aspects   of   anti-­‐tumour  immunity  and  of  regulatory  mechanisms  interfering  with  immune  recognition  of  tumour  cells.  Vaccination  studies  are  on  going  in  patients  with  melanoma,  prostate  and  colon  cancer,  and  neuroblastoma.    The  Rare   Tumour  Network   is   devoted   to   distant   patient   sharing   in   the   area   of   adult   rare   solid   tumours,  primarily  sarcomas,  and  is  linked  to  the  Italian  Sarcoma  Group.  In  the  area  of  Genitourinary  tumours,  INT  is  promoting   innovative   phase   2   trials   with   targeted   agents   in   urothelial   cancer   and   rare   tumours   like  testicular   and   penile   cancer.   Dr   Necchi   is   currently   the   member   of   the   Executive   Committee   of   the  Genitourinary  Cancers  Research  Group  of   the  European  Organisation   for   the  Research  and  Treatment  of  Cancer  (EORTC)  and  member  of  the  Penile  Cancer  Guidelines  Panel  of  the  European  Association  of  Urology  (EAU).      Web:  http://www.istitutotumori.mi.it