Fondazione IRCCS Istituto Nazionale dei Tumori

1. Pathology

G. Pruneri

The  Department of Pathology of the National Cancer Institute of Milan  includes Divisions of Surgical Pathology, Molecular Pathology and Laboratory Medicine, highly integrated and fully equipped with the most recent technologies, including next-generation sequencing platforms. Its mission is to provide clinically actionable diagnoses including all the prognostic and predictive data for patients with all cancer types except CNS tumors. The Department is also very active in translational research, focused on the discovery and the clinical relevance of predictive biomarkers, genomic and epigenetic profiling, and resistance to targeted therapy.

2. Radiation Oncology

 R. Valdagni, C. Fallai

Visiting observership

Intermediate English if Italian is not spoken

The Unit Radiation Oncology 1 (RTO1), directed by Professor Riccardo Valdagni,  and the Unit Radiation Oncology 2 (RTO2), directed by Dr Carlo Fallai, provide curative and palliative radiation to patients with a multidisciplinary approach, according to national and international guidelines or research protocols.  The clinical activity is driven by specialized pathology groups. RTO1 is in charge of the radiotherapy treatment of: breast cancer, pediatric tumors, tumors of the genitourinary district, tumors of the digestive system, lung cancer, soft tissues sarcomas and lymphomas. A specific clinic is reserved to patients who need palliative radiation. RTO2 is in charge of the radiotherapy treatment of head and neck cancer, gynecologic cancer, brachytherapy treatments, cranial stereotaxis and it has a unit with eight beds.

In 2018 1750 patients were treated in RTO1 and 610 patients were treated in RTO2. Particular attention and efforts are dedicated to improve new technologies, such as VMAT, IGRT (Calypso) and High-Dose Rate Brachytherapy (HDRBCT). Hypofractionation is routinely used.  RTO1 unit  participates in international trials and focuses its research activity on the following areas: the development of predictive models of radioinduced toxicity with evaluation of clinical, radiomics and genetic variables and its international validation, specially in prostate cancer. Another research area regards comparison of toxicity data and predictive modeling in a European multicenter project (REQUITE) in breast, lung and prostate cancer; RT techniques and fractionations, such as hypofractionated and partial breast irradiation. The reasearch activity of RTO2 unit is focused, for head and neck cancer,  on a phase II study which involves and observes a multidisciplinary approach (surgery, chemotherapy, radiotherapy with photons and/or heavy ions) on bad prognosis sinonasal tumors (SINTART) in order to get a more efficient and less toxic treatment both in operable or not operable patients. Research activity on  gynecologic cancer observes treatment quality in terms of applicability, clinical and dosimetric outcomes on locally advanced cervix cancer according to the european excellence standards. For some pathologies both of the Radiation Oncology units collaborate with Fondazione CNAO (the National Centre of Oncological Hadrontherapy).

Visiting observers can modulate their training within a unique pathology group or rotating in all the pathology groups of the Radiation Oncology units.

Tutors: N. Bedini, C. Sangalli, A. Cerrotta

3. Hepato-Pancreatic-Biliary (HPB) Oncology: an integrated medical-surgical and interventional training program.

Surgery, Gastroenterology and Hepatology, Oncology, Interventional Radiology

English or Italian

Integrated, multidisciplinary program of diagnosis, treatment and research on malignancies of the liver, biliary tract and pancreas. The program, although based in a surgical-oriented Unit is a comprehensive HPB-Oncology clinical-based program, focused on combined approaches of distinctive specialties integrated in a single, multifaced scheme of decision-making and technical applications. Experiences on clinical trials, technical features, pre-clinical research, medical management of HPB diseases including transplantation are distinctive components that will be developed with the trainees joining the program.

Tutor: Carlo Sposito MD

4. Adult soft tissue sarcomas, bone sarcomas and gastrointestinal stromal tumors

P.G. Casali

English or Italian

Medical Oncology 2 Unit is the medical oncology facility of the Sarcoma multidisciplinary tumor board of Fondazione IRCCS Istituto Nazionale Tumori, Milan, which serves as one of the reference centres in Italy for patients with adult soft tissue sarcomas, bone sarcomas and gastrointestinal stromal tumours. The Unit also coordinates the rare adult cancer professional network within the Italian Rare Cancer Network and the Sarcoma domain of EURACAN, the European Reference Network on rare adult solid cancers.  A full range of inpatient and out-patient services are available for the management of sarcoma patients, covering all sarcoma subtypes. All activities are strongly multidisciplinary, in partnership with the Sarcoma surgical and radiation oncology units. The Unit is actively involved in several national and international clinical trials and has ongoing translational projects especially on very rare sarcoma subtypes. As part of the observership programme, free participation in educational events on sarcomas and rare cancers will be offered.

Tutor: Anna Maria Frezza, Salvatore Provenzano

5. Head and Neck Cancers