DOCSLIB.ORG

Remembering Gianni Bonadonna by KURT SAMSON

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Remembering Gianni Bonadonna by KURT SAMSON 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 Hodgkin lymphoma, 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 adjuvant therapy 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 chemotherapy regimen 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 (cyclophosphamide, 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 15 Oncology Times GIANNI BONADONNA to continue to lead a productive life as Continued from page 14 founder and president of the Fondazione Matthew Ellis’s Michelangelo, remarking that with his G. Komen Interdisciplinary Breast disabilities he was better able to under- Bonadonna Award Lecture Fellowship Program at the University stand the pain his patients were experi- of Texas MD Anderson Cancer encing,” DeVita said. “His approach to atthew Ellis, MD, BChir, PhD, is this year’s recipient of Center, praised Dr. Bonadonna’s many life in the face of adversity was an inspi- Mthe Gianni Bonadonna Breast Cancer Award, an honor contributions to the field of breast ration to us all. bestowed last month at the Breast Cancer Symposium. Read cancer treatment: “Without Gianni “He was a good friend, and I always • Bonadonna’s initial work in demon- enjoyed his company. We shared a love a summary of his award lecture here, online ahead of print: 10/25/15 strating the activity of chemotherapy, of opera and were both always reduced to http://bit.ly/OT-BonadonnaAward-Ellis we would not be where we are today in tears by Puccini’s music during the last terms of the management and the cure 12 minutes of the first act of La Bohème. O of breast cancer,” he said. I will miss him.” T “Bonadonna’s legacy is one of focus, persistence, passion, innovation, and creativity. That’s a tall order for most new members of our profession but clearly is a combination of attributes that make Dr. Gianni Bonadonna a role model for oncology professionals of the future.” Hodgkin’s Disease Award and Lecture His contributions to research in the field of Hodgkin lymphomas also was acknowledged by the Committee of the International Symposium on Hodgkin’s lymphoma in Cologne, Germany, where the organization created the “Gianni Bonadonna Hodgkin’s Disease Award and Lecture.” Over the course of his professional career, in addition to his many research papers, he also wrote books aimed at lay readers, as well as a book on the Sepoy revolt in India, a rebellion in 1857 against the army of the East India Company, regarded as India’s first war of independence. Unorthodox and Dedicated In the interview with OT, Canellos also talked about Bonadonna’s many interests outside of his research pursuits: “Dr. Bonadonna was a very eclectic phy- sician who enjoyed traveling to exotic places. He collected objects of art result- ing in his home being almost a museum in itself.” Similarly, DeVita said that by enthusiastically collaborating with other researchers around the world, Bonadonna gave breast cancer and Hodgkin’s disease what essentially amounted to a treatment makeover, and not just in terms of investigating adjuvant therapies: “He changed the practice of medical oncology in Italy by doing things they had not done before, like telling patients their diagnosis, and that CMF and CMFP were experimental treatments and asking patients for their informed consent. He also adopted rig- orous precepts for clinical trials. This took a great deal of courage on his part, but paid off handsomely for Italian cancer patients.” Bonadonna suffered a serious stroke in 1995, but continued to work toward improving treatment and practice. “He showed a different kind of courage; the courage of a severely disabled patient .
Load more

Recommended publications
  • NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Myeloid Growth Factors
    NCCN Guidelines Index MGF Table of Contents Discussion NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines® ) Myeloid Growth Factors Version 2.2013 NCCN.org Continue Version 2.2013, 08/02/13 © National Comprehensive Cancer Network, Inc. 2013, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. NCCN Guidelines Version 2.2013 Panel Members NCCN Guidelines Index MGF Table of Contents Myeloid Growth Factors Discussion * Jeffrey Crawford, MD/Chair †‡ Susan Hudock, PharmD å Lee S. Schwartzberg, MD † ‡ Þ Duke Cancer Institute The Sidney Kimmel Comprehensive St. Jude Children's Research Hospital/ Cancer Center at Johns Hopkins The University of Tennessee Health Science James Armitage, MD † x Center- The West Clinic UNMC Eppley Cancer Center at Dwight D. Kloth, PharmD å å The Nebraska Medical Center Fox Chase Cancer Center Sepideh Shayani, PharmD City of Hope Comprehensive Cancer Center Lodovico Balducci, MD † ‡ David J. Kuter, MD, DPhil † ‡ Moffitt Cancer Center Massachusetts General David P. Steensma, MD†‡Þ Hospital Cancer Center Dana-Farber/Brigham and Women’s Pamela Sue Becker, MD, PhD ‡ Þ x Cancer Center Fred Hutchinson Cancer Research Center/ Gary H. Lyman, MD, MPH † ‡ å Seattle Cancer Care Alliance Duke Cancer Institute Mahsa Talbott, PharmD Vanderbilt-Ingram Cancer Center Douglas W. Blayney, MD † Brandon McMahon, MD ‡ Stanford Cancer Institute Robert H. Lurie Comprehensive Cancer Saroj Vadhan-Raj, MD † Þ Center of Northwestern University The University of Texas Spero R. Cataland, MD ‡ MD Anderson Cancer Center The Ohio State University Comprehensive Hope S. Rugo, MD † ‡ x Cancer Center - James Cancer Hospital UCSF Helen Diller Family Peter Westervelt, MD, PhD † Siteman Cancer Center at Barnes- and Solove Research Institute Comprehensive Cancer Center Jewish Hospital and Washington University School of Medicine Mark L.
    [Show full text]
  • Breast Pathology
    28A ANNUAL MEETING ABSTRACTS Breast Pathology Clincopathologic parameters n=68(%) Predominant MC 101 Overexpression of FoxO3a Is Associated with Lymph Node Squamous 31(45.5) Metastasis and Poor Disease-Free Survival in Triple-Negative Breast Spindle 15(22) Cancers Chondroid 9(13) Rehman Abdul, Yumin Chung, Hyein Ahn, Jongmin Sim, Min Sung Chung, Kiseok Jang. Osseous 4(6) Hanyang University College of Medicine, Seoul, Republic of Korea. Background: Triple negative breast cancer (TNBC) is the most aggressive type of breast Pseudoangiomatous 6(9) cancer, whichis a heterogeneous group and has no proven molecular target. FoxO3a, Mixed 2(3) a transcription factor, is involved in wide spectrum of biological processes, including HG sarcomatoid 1(1.5) cell cycle progression, proliferation, DNA damage repair, and apoptosis.Recently, DCIS with metaplastic features 14(52) accumulating evidences suggests that FoxO3a act as a tumor suppressorin variety Squamous 11(78.5) of human cancers. However,the previous studies usingTNBC cell lines have shown controversial results. The aim of this study was to investigate the clinicopathological Chondroid 2(14) significance and role of FoxO3a in the progression of TNBC. Rhabdoid 1(7.5) Design: Tissue microarrays consisting of 124 cases of TNBC were studied for FoxO3a None 13(48) expression by immunohistochemistry and interpreted by semi-quantitative scoring Grade system. The FoxO3a expression correlated with various clinicopathological parameters, 1 1(1.5) including patient’s survival. Furthermore, cultured TNBC cell lines (MDA-MB-231, MDA-MB-468, BT20) were assessed for FoxO3a expression by western blot. MDA- 2 3(4.5) MB-468 breast cancer cell line was transiently transfected with exogenous siRNA, 3 64(94) which wasspecific for FoxO3a.
    [Show full text]
  • PATTERNS of FATIGUE and FACTORS INFLUENCING FATIGUE DURING ADJUVANT BREAST CANCER CHEMOTHERAPY by Ann Malone Berger a DISSERTATI
    PATTERNS OF FATIGUE AND FACTORS INFLUENCING FATIGUE DURING ADJUVANT BREAST CANCER CHEMOTHERAPY By Ann Malone Berger A DISSERTATION Presented to the Faculty of The Graduate College in the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy Nursing Under the Supervision of Professor Susan Noble Walker Medical Center Omaha, Nebraska December, 1996 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TITLE Patterns of Fatigue and Factors Influencing Fatigue During Adjuvant Breast Cancer Chemotherapy BY Ann Malone Berger APPROVED DATE 11/25/96 Susan Noble Walker Lynne Farr________________________________ 11/25/96 Anne Kessinger 11/25/96 11/25/96 Ada Lindsey _______________________________________ _______ T . 7. 11/25/96 L a m Zimmerman ______ ___ ______________________ SUPERVISORY COMMITTEE GRADUATE COLLEGE UNIVERSITY OF NEBRASKA Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. PATTERNS OF FATIGUE AND FACTORS INFLUENCING FATIGUE DURING ADJUVANT BREAST CANCER CHEMOTHERAPY Ann Malone Berger, Ph.D. University of Nebraska, 1996 Advisor: Susan Noble Walker, Ed.D. Women beginning adjuvant chemotherapy for breast cancer seek information from health professionals regarding fatigue, but knowledge regarding this distressing symptom is currently limited. The purposes of this study were to describe the patterns of fatigue and of factors influencing fatigue across the first three cycles of chemotherapy and to determine the extent to which health and functional status, chemotherapy protocol, physical activity behaviors, activity/rest cycles, nutrition behaviors and status, stress management behaviors, interpersonal relations behaviors, symptom distress and reaction to the diagnosis of cancer explain fatigue at each treatment and predict fatigue at the mid-point of the first three chemotherapy cycles.
    [Show full text]
  • Protein Expression, Survival and Docetaxel Benefit in Node-Positive Breast Cancer Treated with Adjuvant Chemotherapy in the FNCL
    Jacquemier et al. Breast Cancer Research 2011, 13:R109 http://breast-cancer-research.com/content/13/6/R109 RESEARCHARTICLE Open Access Protein expression, survival and docetaxel benefit in node-positive breast cancer treated with adjuvant chemotherapy in the FNCLCC - PACS 01 randomized trial Jocelyne Jacquemier1,2, Jean-Marie Boher3, Henri Roche4, Benjamin Esterni3, Daniel Serin5, Pierre Kerbrat6, Fabrice Andre7, Pascal Finetti2, Emmanuelle Charafe-Jauffret1,2,8, Anne-Laure Martin9, Mario Campone10, Patrice Viens8,11, Daniel Birnbaum2, Frédérique Penault-Llorca12 and François Bertucci2,8,11* Abstract Introduction: The PACS01 trial has demonstrated that a docetaxel addition to adjuvant anthracycline-based chemotherapy improves disease-free survival (DFS) and overall survival of node-positive early breast cancer (EBC). We searched for prognostic and predictive markers for docetaxel’s benefit. Methods: Tumor samples from 1,099 recruited women were analyzed for the expression of 34 selected proteins using immunohistochemistry. The prognostic and predictive values of each marker and four molecular subtypes (luminal A, luminal B, HER2-overexpressing, and triple-negative) were tested. Results: Progesterone receptor-negativity (HR = 0.66; 95% CI 0.47 to 0.92, P = 0.013), and Ki67-positivity (HR = 1.53; 95% CI 1.12 to 2.08, P = 0.007) were independent adverse prognostic factors. Out of the 34 proteins, only Ki67- positivity was associated with DFS improvement with docetaxel addition (adjusted HR = 0.51, 95% CI 0.33 to 0.79 for Ki67-positive versus HR = 1.10, 95% CI 0.75 to 1.61 for Ki67-negative tumors, P for interaction = 0.012). Molecular subtyping predicted the docetaxel benefit, but without providing additional information to Ki67 status.
    [Show full text]
  • Original Article Efficacy of Metronomic Chemotherapy with Oral Cyclophosphamide and Methotrexate in Patients with Non-Hodgkin
    Int J Clin Exp Med 2016;9(2):3893-3900 www.ijcem.com /ISSN:1940-5901/IJCEM0015875 Original Article Efficacy of metronomic chemotherapy with oral cyclophosphamide and methotrexate in patients with non-Hodgkin lymphoma: a retrospective analysis at a single institution Joo Young Jung, Geundoo Jang, Hunho Song, Hyeong Su Kim, Dae Ro Choi, Jung Hye Kwon, Ho Young Kim, Boram Han, Jung Han Kim, Hyo Jung Kim, Dae Young Zang Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang-si, Korea Received September 8, 2015; Accepted January 12, 2016; Epub February 15, 2016; Published February 29, 2016 Abstract: Metronomic chemotherapy is an emerging strategy offering a potentially less toxic yet effective treatment modality. We evaluated the efficacy and safety of low-dose metronomic (LDM) chemotherapy in relapsed or refracto- ry non-Hodgkin lymphoma (NHL) by retrospectively reviewing the data of 16 NHL patients who were treated with oral cyclophosphamide plus methotrexate (CM) as LDM chemotherapy. The patients received oral cyclophosphamide (50 mg per day) and oral methotrexate (2.5 mg twice weekly) until disease progression or unacceptable toxicity was noted. Fifteen NHL patients were evaluable in the study. The overall best response rate was 53.3% (2 complete responses and 5 partial responses), with 6.7% of patients achieving stable disease. The median treatment duration was 4.8 months (range, 1.45-25.3 months); the median overall and progression-free survival times were 12.1 and 6.6 months, respectively; and the median response duration was 8.7 months. Only 4 patients were managed with further salvage chemotherapy.
    [Show full text]