The Division of Cancer Prevention and Genetics Bernardo BONANNI, MD Director
STAFF Deputy Director: Aliana Guerrieri-Gonzaga, MSc Senior Assistant: Davide Serrano, MD Senior Lab Assistant: Harriet Johansson, MSc Assistant: Massimiliano Cazzaniga, MD, Monica Barile, MD Clinical Monitor: Clara Varricchio, MD Resident: Matteo Lazzeroni, MD Lab Assistant: Debora Macis, MSc Research Nurse : Irene Feroce Nurse: Alessandra Panichi Technician: Mara Jo Miller Data Manager: Serena Mora, Giorgia Bollani, Chiara Bresciani Secretary: Alessandra Rossi, Raffaella Falcone Patient Manager: Angela Maniscalco Scientific Consultant: Andrea Decensi, MD
48 IEO — Scientific Report 2009 — Ongoing research 2010
Activities 2009. The Division of Cancer Prevention and Genetics is essentially dedicated to clinical research on the prevention of solid tumors and clinical management (risk assessment, surveillance and preventative treatment) of subjects at higher-than-average risk for various types of cancer. In order to develop new strategies of cancer prevention the Division’s multidisciplinary staff (including oncologists, geneticist, biologists, research nurses, data managers) is committed to conduct clinical trials with the main aim to validate various drugs, micronutrients, natural compounds as preventive agents. Most of the research efforts are currently focused on chemoprevention trials on breast, ovarian, colorectal and lung cancer. The target population is heterogeneous but includes mainly two groups of at-risk subjects; 1) patients with (previously resected) precancerous conditions (such as breast ductal intraepithelial neoplasias, colon adenomas); 2) healthy individuals who carry one or more risk factors (such as family history, germinal mutations, high levels of androgens or estradiol or IGF-1, use of HRT, metabolic syndrome/insulin resistance, breast lobular intraepithelial neoplasia or athypical hiperplasia, high mammography density, peripheral lung “ ground glass opacities” etc). These at-risk subjects are initially selected, followed and preferably enrolled in chemoprevention trials. We have an established experience on various types of trials, including: a) phase II studies on surrogate endpoint biomarkers; b) larger phase III, multiinstitutional trials on clinical endpoints (cancer incidence); c) pre-surgery, “window-of-opportunity” studies in patients candidate to surgical treatment for primary breast cancer in order to test the efficacy of new and “old” drugs on breast cancer cell proliferation (measured by Ki-67 on baseline biopsy and then on the specimen after 3-4 weeks of drug treatment), and other tissue and circulating biomarkers. Since phase III trials typically last several years before providing results, we put much effort in the creation and