Michele Reni, MD
Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan (Italy)
My medical training and my professional career have been held at the Oncology Scientific Institute San Raffaele, where I specialized first in radiation oncology and then medical oncology.
I got involved into pancreatic cancer studies by chance, at the beginning of 1997. At that time, the disease was managed only by surgeons. I was passing by chance in front of the office of my supervisor while the head of pancreatic surgery, Professor Di Carlo, was complained about the nihilism of the oncologists in respect to pancreatic cancer and he asked to identify a contact person who will roll up their sleeves and try to do something more. Since then, about twenty independent clinical trials have been promoted by our group.
Among the most important trials, I remember the first worldwide study that demonstrated the superiority of the association of chemotherapy compared to the use of a single drug in treating the disease in advanced stage and surgically unresectable cancer. This work was published 10 years ago on the prestigious journal “Lancet Oncology”. The positive effect of this combination of drugs was confirmed independently by a French group in 2011 and by a pharmaceutical company in 2013.The scheme was subsequently modified (studies PACT-5, 6-PACT PACT-9), it confirmed the results, it improved the tolerance and simplifyed the logistics for the benefit of the patients. The study PACT-17, recently concluded and published, further confirmed that the schema with 4 drugs is able to obtain, on a less selected population of patients, the same results obtained by FOLFIRINOX, a much more toxic and difficult drug to administer.
Our group was the first in the world to complete, with very promising results, a study (PACT-7) comparing a combination of chemotherapy with the use of a single drug for postoperative treatment of patients undergoing surgical removal of the tumor. Other studies are currently taking place worldwide to study this effect.
The concept of “maintenance therapy” with the use of antiangiogenic drugs after chemotherapy for metastatic disease has been introduced, for the first time and with success, in a multicenter study (PACT-12) coordinated by San Raffaele Hospital.
Over the years the consolidation of an intensive multidisciplinary collaboration with surgeons, radiotherapists, gastroenterologists, radiologists, pathologists, nuclear physicians leaded to initiate and conclude a number of research projects and to improve the theraphy for patients. The interaction between translational and basic research has grown consistently allowing comprehensive research projects to take place in order to learn more about the disease.
