Angelo Di Leo, MD, PhD
Head of Sandro Pitigliani Medical Oncology Unit
Department of Oncology
Hospital of Prato, Istituto Toscani Tumori
2013-2014 BCRF Projects:
Dr. Di Leo is exploring the differential sensitivities of breast cancer subtypes to chemotherapeutic agents that directly damage the DNA of cancer cells, compared with non-DNA-damaging chemotherapy. In addition, his team is evaluating cancer cells circulating in the blood, known as circulating tumor cells (CTCs). These cells are also known as tumor-initiating cells and are thought to trigger the growth and expansion of cancer into otherwise healthy tissues. Dr. Di Leo’s team is refining a method that first captures CTCs, then isolates single pure CTCs. Specific markers on CTCs can then be assessed to improve understanding of both of breast cancer biology and why some treatments work better than others. They are also looking at whether CTCs are present after breast cancer surgery and if these cells can be measured and analyzed for specific genetic markers in order to improve understanding of cancer biology and behavior.
Different types of chemotherapy may be particularly active in some subtypes of breast cancer. In particular, triple negative breast cancer might be more sensitive to chemotherapy that damages tumor DNA. Dr. DiLeo and colleagues are exploring the effect of DNA-damaging and non-DNA-damaging chemotherapy in metastatic breast cancer and looking at response based on the subtype of breast cancer and other tumor characteristics. They are also researching novel techniques for measuring specific tumor markers on tumor cells that can be found in the blood of some women with metastatic breast cancer (known as circulating tumor cells). The researchers have already defined one method for looking at mutations in a known breast cancer-related gene on circulating tumor cells and are now working to refine and validate this method, as well as adapt it to look at additional gene mutations. Furthermore, they are comparing this method with different approaches to analyzing tumor genes. The characterization of genetic changes in tumors seen in circulating tumor cells might allow improved prediction of disease course and response to chemotherapy or other anticancer medicines.
Dr. Di Leo will also be collaborating with fellow BCRF grantee, Dr. Monica N. Fornier (Memorial Sloan-Kettering Cancer Center) on a separate project on metabolomics. There is much exciting data emerging about metabolic changes associated with breast cancer. Drs. Di Leo and Fornier are using metabolomics –the rapid, high throughput characterization of the small molecule metabolites found in an organism – to explore a model in which serum detectable metabolic profiles correlate with disease recurrence. Furthermore, they are evaluating whether the combination of metabolomics and the 21 gene recurrence score (OncotypeDx®) genomic test, might further improve prediction of disease recurrence, and thus refine prognostication in individuals with early stage breast cancer.
Drs. DiLeo and Fornier have already found promising results from the first part of this project and are now investigating firstly whether these results can be confirmed in a larger group of women, and secondly whether metabolomics can be effectively combined with another risk prediction test, Oncotype DX, which looks are tumor genetic changes. Results from these projects could help improve the ability to select which women with early breast cancer are at higher risk of disease recurrence and therefore would have the most benefit from the addition of chemotherapy after their breast cancer surgery.
Dr. Angelo Di Leo is currently Head of the Sandro Pitigliani Medical Oncology Unit, and Chair of the Oncology Department, at the Hospital of Prato, Istituto Toscano Tumori, Italy, a position which he took up in September 2003. The center is affiliated to the International Breast Cancer Study Group (IBCSG).
Dr. Di Leo graduated in Medicine and Surgery from the University of Palermo (Italy) in 1988, received his postgraduate diploma in Medical Oncology from the University of Pavia (Italy) in 1992 and in 1996, received his European certification in Medical Oncology, which was issued by the European Society for Medical Oncology (ESMO). Dr. Di Leo received his training at the National Cancer Institute in Milan, where he worked for seven years until 1996. From 1996 to 2003 he worked at the Chemotherapy Unit of the Jules Bordet Institute in Brussels, where in 2000 he was appointed Associate Director and Medical Director of the BREAST. Dr. Di Leo was also Associate Member of the Oncology course teaching faculty at the Free University of Brussels.
Dr. Di Leo's main field of research is breast cancer and he has been involved in the coordination of a number of international, pivotal Phase III trials designed to evaluate the efficacy of new adjuvant therapies for breast cancer. Dr. Di Leo is also largely involved in the evaluation of molecular markers with potential predictive value in the treatment of breast cancer patients. Dr. Di Leo is a member of the Early Breast Cancer Trialists' Cooperative Group (EBCTCG) steering committee and he has been a member of the American Society of Clinical Oncology (ASCO) grants selection committee (2006-2009). Dr. Di Leo is the author of several articles that have been published in peer-reviewed international journals and has lectured extensively at national and international meetings.