14 Remembering Gianni Bonadonna BY KURT SAMSON

ianni Bonadonna, in previously un- MD, whose revo- treated women.”

oncology-times.com lutionary research Bonadonna’s • in combina- proposed regimen Gtion adjuvant chemotherapy of CMF and then helped transform the treat- CMFP was found ment of both breast cancer to be very active in and , died achieving remis- Sept. 7, in Italy, at the age of sion of disease, 81. Canellos said. “Dr. His research has helped re- DeVita and I were October 25, 2015 duce morbidity and mortality in the process of • for millions of patients after compiling our data introducing for review by the at a time when radiotherapy leadership and we and radical mastectomies were hoped to use it to standard practice. keep early breast A widely revered, beloved, cancer from me- charismatic, and internation- tastasizing. At that ally acclaimed investigator, time, however, the Bonadonna published over Gianni Bonadonna, MD (1934-2015) centers and other Oncology Times 550 papers and received nu- U.S. oncology merous awards for his revolutionizing Vincent DeVita groups were reluctant to participate.” work. Until his death he chaired the In an interview, DeVita, Director of Today, adjuvant chemotherapy is a Committee on Prospective Clinical the National Cancer Institute from standard practice in treating breast can- Trials at the Istituto Nazionale dei 1980 to 1988 and now the Amy and cer recurrence and metastases in many Tumori in Milan. Joseph Perella Professor of Medicine women undergoing therapy. Although his early findings on the and Medical Oncology at Yale Cancer potential of early adjuvant therapies Center, remembered working with were not initially embraced by the Bonadonna in the early years: “I first The Early Years ­oncology community in general, in the met him when he spent a week with us Gianni Bonadonna was born on July decades since, his and others’ research at the NCI Medicine Branch in 1969 28, 1934, in Milan. After he gradu- helped establish combination regimens going over the CMF protocol we had ated from the University of Milan in that are today considered the optimal developed and modifying it for use 1959 with a degree in Medicine and approach for treating many of these as adjuvant chemotherapy in breast Surgery he studied in the U.S. between cancers. cancer. 1961 and 1964. During his postdoc- In 1972, Dr. Bonadonna and his col- “No one in this country would touch toral training from 1961 to 1964 he leagues published preliminary findings it at the time, but Gianni adopted it was a research fellow at Memorial in early trials among Hodgkin’s patients and ran the trial in Italy, with the NCI Sloan Kettering Cancer Center, in at Italian institute using a new combi- ­providing support. That 1976 trial, New York. After returning­ to Italy nation called published­ in NEJM, rocketed him to he joined the Istituto Nazionale dei ABVD (doxorubicin [Adriamycin], fame.” Tumori of Milano, where he stayed for bleomycin, vinblastine, and dacarba- the rest of his life. In 1976 he became zine). They determined that ABVD was the Director of Medical Oncology and more effective than the MOPP regimen George Canellos in 1991 ­became the Head of Cancer (mustargen, oncovin, procarbazine, George P. Canellos, MD, the William Medicine at the Milan institute. and prednisone), then the standard Rosenberg Professor of Medicine at His work in adjuvent therapy for combination. Harvard Medical School, who prac- breast cancer and Hodgkin’s disease Developed in the 1960s at the U.S. tices at Dana-Farber Cancer Institute, included the first trials of doxuru- National Cancer Institute by research- also recalled those days. At the time bicin, bleomycin, and epirubicin. In ers that included Vincent T. DeVita, Jr., he was a clinical associate at the NCI, ­subsequent years he was awarded MD. MOPP was the first combination and from 1975 to 1995, he was Chief many national and international chemotherapy regimen to result in high of Dana-Farber’s­ Division of Medical honors. success rates in Hodgkin’s disease and Oncology; a former Editor-in-Chief other blood cancers. of the Journal of Clinical Oncology In 1973, Bonadonna and his and a past president of the American Breast Cancer Award ­colleagues published a groundbreak- Society of Clinical Oncology, Canellos and Lecture ing study in the New England Journal is currently a senior physician­ at In recognition of his many contri- of Medicine that demonstrated the ­Dana-Farber and Brigham and butions to cancer treatment, the ­effectiveness of combined chemother- Women’s Hospital, and was a major American Society of Clinical Oncology apy using CMF (, figure in the emerging field of adjuvant in 2007 established the “Gianni ­methotrexate, and fluorouracil) for treatment while a visiting investigator Bonadonna Breast Cancer Award and node-positive operable breast cancer. in Milan. Lecture.” This was then confirmed in a 30-year “I first got to know Dr. Bonadonna In announcing the creation of follow-up review of treated breast when he came to the National Institutes that award, ASCO then-President ­cancer cases, published in 2005. That of Health to see if the NCI was involved Gabriel Hortobagyi, MD, Professor study showed that CMF, especially with with adjuvant therapy for breast can- of Medicine, in the Department of the addition of prednisone (CMFP) sig- cer. Indeed, we were in the process of Breast Medical Oncology, the Nellie nificantly reduced the risk of recurrence completing a trial of combination che- B. Connally Chair in Breast Cancer, and death. motherapy for metastatic breast cancer and Program Director of the Susan • 10/25/15

15 Oncology Times

Matthew Ellis’s Ellis’s Matthew Bonadonna Award Lecture Bonadonna Award atthew Ellis, MD, BChir, PhD, is this year’s recipient of of recipient year’s PhD, is this BChir, atthew Ellis, MD, an honor Cancer Award, Breast the Gianni Bonadonna bestowed last month at the Breast Cancer Symposium. Read Read Cancer Symposium. at the Breast bestowed last month print: of ahead online here, lecture award his of summary a http://bit.ly/OT-BonadonnaAward-Ellis M -

T O

“He was a good friend, and I always I always and was a good friend, “He to continue to lead a productive life as as life leadproductive a to continue to of and president the Fondazione founder that with remarking his Michelangelo, under to able he was better disabilities experi - were patients his pain the stand to approach “His said. DeVita encing,” of in the face life inspi- was an adversity us all.ration to a love shared We his company. enjoyed to reduced ofboth always opera were and during last the music Puccini’s by tears of12 minutes the first actof La Bohème. I will him.” miss patient patient pursuits: pursuits: , Canellos Canellos , courage; the the courage; investigating investigating researchers around the world, world, the around ­researchers - was a very Bonadonna eclectic phy Similarly, DeVita said that by by that said DeVita Similarly, Bonadonna suffered a serious stroke a serious stroke suffered Bonadonna Over the course of his professional of the course his professional Over “Bonadonna’s legacy is one of focus, legacy of is one focus, “Bonadonna’s “Dr. exotic to traveling whosician enjoyed objects collected of He art- result places. being almost a museum ing in his home in itself.” collaborating with ­enthusiastically other and cancer breast gave Bonadonna what disease essentially Hodgkin’s makeover, treatment a to amounted of in terms and not just ­ In the interviewIn with OT many Bonadonna’s about talked also ­ of outside his research ­interests the changed “He therapies: adjuvant practice of by medical oncology in Italy things theydoing before, had not done and diagnosis, patients their telling like experimental that CMF and CMFP were their and asking patients for treatments rig- also adopted He informed consent. This trials. clinical for precepts orous of deal a great took his part, on courage paid offbut Italian for handsomely ­cancer patients.” toward work to continued but 1995, in “He and practice. treatment improving kind of a different ­ showed of disabled ­ courage a severely Unorthodox and Dedicated Unorthodox His contributions to research in the the in research to contributions His offield Hodgkin lymphomas was also of the Committee by the acknowledged Hodgkin’s on Symposium International where Germany, lymphoma in Cologne, “Gianni the the organization created Award Disease Hodgkin’s Bonadonna and Lecture.” research his many in addition to career, books aimed he also wrote papers, as well as a book the on readers, at lay in a rebellion in India, revolt Sepoy of1857 against the army the East India of war first India’s as regarded Company, independence. Hodgkin’s Disease and Lecture Award G. Komen Interdisciplinary Breast Breast Interdisciplinary Komen G. University at the Program Fellowship Cancer Anderson MD of Texas many Bonadonna’s praisedDr. Center, field the of to ­contributions breast Gianni “Without treatment: cancer - in demon initial work Bonadonna’s strating the activity of chemotherapy, in today are we not be where would we ofterms and the cure the management he said. of cancer,” breast and innovation, passion, persistence, most for a tall order That’s creativity. but of members new our profession of is a combination clearly attributes a Gianni Bonadonna Dr. that make oncology professionals model for role of the future.” GIANNI BONADONNA Continuedfrom page 14