Head of Sandro Pitigliani Medical Oncology Unit
Department of Oncology Hospital of Prato
Istituto Toscani Tumori
Triple negative breast cancer (TNBC) is characterized by cancer cells that do not have the estrogen or progesterone receptors and do not overexpress the HER2 receptor. Treatment of TNBC is hampered by the diverse types of this disease and variations in response to treatment from patient to patient, making it difficult to predict what therapy will work best for a specific tumor. However, many triple negative cancers are defective in DNA repair, making them very vulnerable to anti-cancer agents that target DNA. Dr. Di Leo and colleagues are conducting a clinical trial to compare two chemotherapy drugs that work in different ways: one causes DNA damage in the cancer cell and the other does not. They will incorporate an innovative approach to define a tumor as triple negative by examining the biological characteristics of circulating tumor cells (CTCs) isolated from the blood of each patient participating in the study, what scientists call a liquid biopsy. CTCs are tumor cells that have become dislodged from the tumor and entered the circulation. With the use of advanced technologies to isolate and characterize CTCs, liquid biopsies may someday be used to provide the clinician with information on biological characteristics of the tumor before starting the cancer treatment, as well as during treatment to monitor response. Dr. Di Leo’s team will use the technology to more accurately identify triple negative tumors in addition to standard pathology review of the tumor biopsy.
In a separte study , Dr. Di Leo is collaborating with BCRF colleague Monica Fornier to study whether metabolites in blood of women with early stage breast cancer can help predict the likelihood of breast cancer recurrence. Metabolomics is a relatively new scientific field in cancer, but one with great potential. It focuses on the molecules that are created during normal cellular processes. These molecules, called metabolites, are often found in the blood or other bodily fluids and can be used to determine what kinds of processes are occurring in the cell. Changes in the types and amounts of metabolites occur in cancer and can provide important clues about the cancer. Drs. Di Leo and Fornier will also test whether the metabolite profile of a breast cancer patient can be combined with another risk prediction test, called Oncotype DX, which looks at genetic changes of the tumor. Results from these projects could help identify women with early breast cancer who are at higher risk of disease recurrence and would have the most benefit from chemotherapy after their breast cancer surgery.
Angelo Di Leo is Head of the Sandro Pitigliani Medical Oncology Dept. at the Hospital of Prato, Istituto Toscano Tumori, Italy, since September 2003. He trained at the National Cancer Institute in Milan, where he worked for seven years. From 1996 to 2003, he was with the Chemotherapy Unit of the Jules Bordet Institute in Brussels, and was appointed senior staff member in 1997.
His main research interest is breast cancer and he has coordinated a number of international, pivotal Phase III trials in new adjuvant therapies. He is also involved in the evaluation of molecular markers with potential predictive value to treat breast cancer patients. He is a member of the Early Breast Cancer Trialists’ Cooperative Group steering committee and of the Scientific Advisory Council of the Susan G Komen for the Cure®, and was a former member of the ASCO grants selection (2006–2009) and educational (2012-2014) committee. He serves as member of the Breast International Group Executive Board.