SCIENTIFIC DIRECTORATE

SCIENTIFIC DIRECTORATE SCIENTIFIC DIRECTOR Marco A. Pierotti, PhD +39 02 2390 2300 marco.pierotti@istitutotumori.mi.it The responsibilities of the Scientific Directorate traditionally include: coordination of research and education activities, planning of scientific policy, and evaluation of scientific projects (Committee of the Scientific Directorate); management of institutional relationships with key health authorities at a regional and national level; support to researchers seeking public and private funding (Grant Office); giving access to information resources in support of ongoing research programs (Biomedical Library); enhancement of communication and collaboration among all cancer-related institutions in Lombardy (Lombardy Oncologic Network); supervision of the Institute s scientific communication in agreement with the President of the INT Foundation; management of the Clinical Trial Center, a core office to support clinical studies, especially investigator driven and Phase I and II studies, with the aim of bringing research results and new treatments to the bedside in the shortest time (see page 61); Working in tight cooperation with the Technology Transfer Office (TTO), the Scientific Directorate also facilitates transfer of inventions and knowledge from INT labs to the public. Each year the Scientific Directorate organizes a Research Day: the 2013 edition was held on June 14th at INT. The meeting offers an opportunity to look back to the scientific accomplishments achieved during the year, and to look forward to future research. Staff Members Tiziana Camerini, Maths D; Aurora Costa, Biol Sci D; Cecilia Melani, MD, PhD Secretariat Laura Ballariano Rossi; Eleonora De Palo, MA Mod Lang; Lucia De Zorzi; Antonio Florita, B Litt International Relations and Linguistic Consultant Daniela Majerna, MA Phil Grant Office Valeria Anselmi, MA Lett; Marco Asioli; Costanza Bono, MA Pol Sc; Sabrina Braghieri, MA Mod Lang; Claudia Casoli; Stefania Didonè;Isabella Russo, MA Econ Lombardy Oncology Network (ROL) Rosaria Bufalino; Marco Tricomi, MS Eng Biomedical Library Rossella Ballarini; Marina Calderisi Editorial Office Rosaria Parentela Tumori - Editorial Assistant Elena Morittu Clinical Trial Center Data Manager: Valentina Sinno, BSc (coordinator); Anisa Bermema, BSc; Liana Bevilacqua, BSc; Ilaria Bossi, BSc; Federica Brunero, BSc; Laura Concas, BSc; Debora Deglinnocenti, Biol Sci D ; Federica Favales, BSc; Rosaria Gallucci, BSc ; Elisa Grassi, BSc; Rosanna Montone, BSc; Paola Pistillo, BSc; Iolanda Pulice, BSc; Dominique Ronzulli, BSc; Silvia Sesana, BSc; Eleonora Sparacio, BSc; Irene Vetrano, BSc Statisticians: Luigi Mariani, MD (coordinator); Monica Pacifici, Stat D Scientific and Administrative Secretariat: Paola V. Consonni Research Nurses: Benedetta Bardazza; Alessandra Castano; Ilaria Lo Russo; Giulia Saba; Serena Scrudato; Edoardo Tulli Baldoin Pharmacovigilance: Elena Togliardi, Pharm D 8

scientific directorate COMMITTEE OF THE SCIENTIFIC DIRECTORATE Marco A. Pierotti, Scientific Director Emilio Bombardieri, Director Diagnostic Imaging and Radiotherapy Department (until August 31) Paolo Corradini, Deputy Scientific Director, Director Hematology and Pediatric Onco-Hematology Department Vito Corrao, Chief Medical Officer Maria Grazia Daidone, Director Experimental Oncology and Molecular Medicine Department Filippo de Braud, Director Medical Oncology Department Alessandro M. Gianni, Deputy Scientific Director Martin Langer, Anesthesia, Intensive Care, Pain Therapy, and Palliative Care Department Alfonso Marchianò, Director Diagnostic Imaging and Radiotherapy Department (since September 1st) Vincenzo Mazzaferro, Deputy Scientific Director Ugo Pastorino, Director Surgery Department Giuseppe Pelosi, Director Pathology and Laboratory Medicine Department Mario Santinami, Deputy Scientific Director Gustavo Galmozzi, Medical Director The Committee is the Institutional Reviewer Board and assists the Scientific Director in defining the Strategic Scientific Program and the contents of correlated educational activities. Its main objectives are: definition of research areas at INT approval of multidisciplinary research projects approval of the development of research projects at a scientific and administrative level evaluation of scientific quality and feasibility of newly-proposed clinical studies prior to submission to the Independent Ethics Committee evaluation of educational programs for residents and non-residents. In 2013, Emilio Bombardieri, for many years head of the Department of Diagnostic Imaging and Radiotherapy and a member of the Committee, retired after a successful clinical and scientific career. The Committee welcomed Alfonso Marchianò who was appointed as new Director of the Diagnostic Imaging and Radiotherapy Department. GRANT OFFICE The Grant Office (GO) has the mission of supporting research activities within the INT, facilitating access to external financing, both national and international, by looking for relevant information in the appropriate media, making direct contact with public and private funding agencies, and swiftly providing information to potentially interested researchers. Announcements regarding funding possibilities are constantly updated in the Calls for Application section of the INT IntraNet website on the Scientific Directorate web page. A section of the website is dedicated to the 7th Framework Program and a new section to Horizon 2020 (the next EU research and innovation program). It is the duty of the GO to help investigators in preparing and submitting grant applications, promote collaborations among researchers at INT and in other public services, and help them to collaborate on research projects. At the Scientific Directorate office, databases are continuously updated according to emerging needs. The database stores information regarding research projects and INT publications to monitor scientific productivity. The GO maintains contact with the officers in charge of research at the Ministry of Health 9

and at the Health Management offices of the Lombardy Region. The activities of the GO include management of ongoing Institutional Projects and design of calls aimed at distributing the funding coming from the Italian 5 tax donation. In 2013, the GO provided support for INT researchers in: 61 applications for public funding (Ministero della Salute); 135 applications to private national funding agencies (Associazione Italiana per la Ricerca sul Cancro, Fondazione Berlucchi, Fondazione Cariplo, Fondazione Monzino, etc.) and 42 international funding bodies (American Institute for Cancer Research, Chordoma Foundation, European Commission, Mesothelioma Applied Research Foundation, Swiss Bridge, WIN Consortium, etc.). LOMBARDY ONCOLOGIC NETWORK (ROL) The Lombardy Cancer Network (ROL: Rete Oncologica Lombarda ) provides a network of organizations and professionals connecting all cancer resources in the region, with over 10,000,000 citizens, in an effort to improve the quality of cancer care and sharing patient data. INT has been the implementing body of the ROL and the Scientific Directorate coordinates all activities since its start-up. ROL is based on clinical cooperation, exchange of information, and sharing and integration of existing cancer facilities. The main goal is the assessment of appropriateness of cancer care on a population level to improve the quality of care by focusing on the cost/efficacy ratio in order to reduce healthcare costs. ROL aims to organize clinical governance resorting to an innovative, feasible, measurable model based on networking of services and providing health benefits to the patient; 58 oncology units are included. ROL designed evidence-based clinical practice guidelines for all solid tumors developed through a consensus process among the oncology community to make a comprehensive impact on clinical oncologic practice. A set of common clinical practice guidelines are annually updated. For each solid cancer, guidelines list all main clinical presentations ( disease phases ) along with their treatment options. ROL upgraded the existing non-structured electronic clinical discharge report into a field-based resource, with both free-text and codified fields. Two codified fields enlist, respectively, disease phases as per guidelines, and the corresponding treatment options. If they match, the strategic medical decision is considered tentatively appropriate. In 2013, more than 61,000 reports were released. Started in 2012, a research project to set up a system that is able to integrate and analyze all available clinical knowledge and guidelines and correlate this with patient data is ongoing in collaboration with IBM-Italian team and IBM Research-Haifa, Israel to detect causes of mistakes and mismatches by automatically analyzing free-text fields. The system, in addition to the analysis of encoded data, has provided key elements, automatically extracted from text, populating a knowledge model on clinical decisions. BIOMEDICAL LIBRARY The INT Library is affiliated with the European Association for Health Information and Libraries. It offers on-site access to a large collection of basic science paper journals and reference books and electronic access to full text journals, bibliographic databases, and electronic books. The mission of the INT Library, specialized in oncology, is to provide access and management services aimed at meeting the needs of physicians, researchers, and students for the efficient retrieval of information needed for best patient care, advanced research, and postgraduate education. Through participation to the SBBL and Bibliosan consortia, the Library s electronic resources give access to over 9000 titles. Bibliosan also has a remote access option enabling Institute staff to access its services from external sites. The library also offers access to specialized data banks of bibliographic references and 10

scientific directorate electronic documents such as Medline, Toxnet, Embase, Cochrane Database of Systematic Review (specialized in EBM), Springer E-book, and Springer Images. The international nursing literature is covered by CINAHL The Cumulative Index to Nursing and Allied Health Literature, with the full text for over 770 journals and 275 books/ monographs in this field. The Library s collection is supplemented by interlibrary loan services with access to the following catalogues: GIDIF-RBM: a consortium of key Italian biomedical libraries SBBL: Biomedical Library System of Lombardy BIBLIOSAN: a network of 50 Italian Research Institutions sponsored by the Italian Ministry of Health. The library is also a member of ACNP, the National Archival Collection of Periodicals, and is thus linked to over 2300 Libraries in Italy and over 110,000 journals and the Italian framework Nilde (Network for Inter-Library Document Exchange). Library customers can access RefWorks, which is a personal bibliographic management software designed to help researchers gather, manage, and store information, as well as generate citations and bibliographies. To disseminating information via the constantly updated Intranet Library web page, various courses are held to help researchers gather information more easily. EDITORIAL BOARD OF TUMORI In 2013, the Editorial Board of Tumori received 717 manuscripts for publication. In the same year, 6 issues containing 183 reviews, original articles, and case reports were published. For each issue, 5,000 copies were printed. EDITORIAL OFFICE The Editorial Office coordinates and manages all activities related to the production of materials that describe the clinical and scientific activities of the INT. In addition, the Editorial Office oversees the publication of the annual Scientific Report and Brochure, and provides support to individual departments for preparation of more specific materials such as brochures and meeting reports. 11

AWARDS AND RECOGNITIONS The Comitato Ospedale Donna of the Osservatorio Nazionale sulla Salute della Donna (O.N.Da) awarded the Fondazione IRCCS INT with three Bollino Rosa prizes for its care in the research and treatment of female diseases and its attention to the specific needs of admitted women. The School of Management del Politecnico di Milano awarded the INT for innovation in health care. Recognition given in the category Clinical Governance and decision support for the project Clinical Analytics for Oncology Care Appropriateness computer system developed in collaboration with IBM. This is an innovative technology solution that provides clinicians with decisional support to evaluate the best treatment for each patient according to clinical reference. Starting from the clinical data provided by INT, a first prototype of a platform for data analysis and decision support for clinicians was built. The system also allows retrospective analysis of the effectiveness of treatment programs already carried out, and compare them with guidelines and decisions made in previous similar cases. The future development of this system will allow associating the cost of processing in order to obtain feedback on the appropriateness and sustainability of the care delivered. Dr. Egidio Riggio of the Plastic and Reconstructive Unit has named Editor in Chief of the Surgical Techiques Development, a new scientific journal with eissn 2038-9582. All contents published in this journal are considered Open Access. Drs. Paolo Bossi and Lisa Licitra of the Head & Neck Cancer Medical Oncology Unit won the Swiss Bridge Award 2013 with the project: Health and economic outcomes of two different follow-up strategies in effectively cured advanced head and neck cancer. Dr. Gemma Gatta, Head of the Evaluative Epidemiology Unit, was invited to participate in the selection for the establishment of the European Union Expert Group on Rare Diseases. Dr. Gabriella Sozzi, Head of the Tumor Genomics Unit, became President Elect of the Italian Cancer Society (SIC). Dr. Elda Tagliabue, Head of the Molecular Targeting Unit, was named a member of the Scientific Board of the SIC. Dr. Carlo Sposito of the Gastrointestinal and Hepatopancreatobiliary Surgery and Liver Transplantation Unit was conferred the Giovani Ricercatori award of the Fondazione IRCCS INT. Dr. Veronica Biassoni of the Pediatric Oncology Unit was conferred the Giovani Ricercatori award of the Fondazione IRCCS INT. Dr. Elena Tassi of the Immunobiology of Human Tumors Unit was conferred the Giovani Ricercatori award of the Fondazione IRCCS INT. Dr. Silvia M. Taverna of the Technology Transfer Office was conferred the Management Support to Research award of the Fondazione IRCCS INT. 12