Dario Trapani

• Doctor of Medicine
• IEO - Istituto Europeo di Oncologia

Background: Hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2−) breast cancer (BC) is more prevalent in male patients compared to female counterparts. Gender associated differences along with molecular differences, immune system, and other factors might play a crucial role in disease management. Here, we characte...

Background: Resistance to endocrine therapy (ET) in HR+/HER2- advanced breast cancer (BC) can be classified as primary (PETR) or secondary (SETR). It is unclear if the two clinical patterns are characterized by distinct molecular mechanisms. In the GLIDER study, we analyzed the genomic landscape of PETR and SETR BCs to identify the possible drivers...

Background: Following to an initial disease control to systemic treatment, 15-20% of patients (pts) with metastatic breast cancer (mBC) experience oligoprogression of disease (OPD) in ≤5 extracranial sites. These pts may benefit from radiotherapy (RT) to OPD sites, while maintaining the same systemic treatment, aiming at prolonging the progression-...

Background: Human epidermal growth factor receptor 2 (HER2) gene expression is an important predictive and prognostic biomarker in breast cancer (BC), which also guides treatment recommendations. The expression of HER2 is a continuum from null to positive and includes HER2-low and ultra-low as targets for anti-HER2 antibody–drug conjugates (ADC). H...

Background: Male breast cancer (MaBC) represents a rare entity, accounting for only 1% of all BC cases. In a previous work, we reported that MaBC recapitulates a unique mutational repertoire, harboring a distinct immune and genomic landscape across BC clinical subtypes. However, prognostic implications of pathway alterations in MaBC have not been r...

Background: Male breast cancer (BC) accounts for less than 1% of new BC cases annually. Androgen receptor (AR), a member of steroid and nuclear receptor superfamily is emerging as an important factor in pathobiology of BC. While the estrogen receptor (ER) is well-studied in BC, the role of the AR is less understood, particularly in male patients. H...

Background Access to immune checkpoint inhibitors remains limited due to cost-effectiveness and affordability concerns. This study evaluates the financial impacts of expanding global access to PD1/PD-L1 inhibitors as first-line monotherapy for patients aged 40–74 years with advanced unresectable non-small cell lung cancer (NSCLC), with wildtype EGF...

11019 Background: Randomized clinical trials (RCTs) remain the gold standard for evaluating the efficacy and safety of novel cancer therapies. Some RCTs are well-designed and show meaningful improvements in patient outcomes while others are confounded by various types of bias, or do not reflect outcomes that matter to patients. Published RCTs shoul...

9018 Background: The Common Sense Oncology (CSO) movement advocates for high-quality, patient-centered cancer care by emphasizing evidence-based, patient-relevant outcomes and equitable access to care through improved evidence generation, interpretation, and communication. A key part of CSO’s mission is training oncologists to incorporate these pri...

1518 Background: Lung cancer is the most common cancer and cause of cancer death, encompassing for 16.8% of all cancer-related deaths worldwide. Anti-PD(L)1 Immune Checkpoint Inhibitors (ICIs) as monotherapy currently represent the standard of care (SoC) for advanced Non-Small Cell Lung Cancer with high (≥50%) PD-L1 expression in high-income countr...

1526 Background: Immune checkpoint inhibitors (ICIs) targeting the PD-(L)1 pathway have revolutionized cancer therapy, but their high costs significantly limit accessibility, particularly in low- and middle-income countries (LMICs). Low-dose regimens may offer a viable solution to this challenge. This systematic review analysed study designs, dosin...

1517 Background: People living with HIV (PLWH) have an increased risk of developing cancers compared to the population without HIV, with cancer being the leading cause of death for this population in high-income countries. Previous research by the ASCO-led HIV working group found only 11% of clinical trials supporting FDA cancer therapy approvals f...

517 Background: The CDK4/6 inhibitor abemaciclib (abema) is approved with adjuvant endocrine therapy (ET) for high-risk node positive hormone receptor positive (HR+) HER2- breast cancer. This regimen reduces cancer recurrence, yet therapy may be complicated by toxicity, limiting patient (pts) ability to maintain dose or continue medication. In the...

1106 Background: TNBC, although an aggressive breast cancer (BC) subtype, is highly immunogenic and the only BC subtype where the ICI pembrolizumab is approved. However, predictive biomarkers for pembrolizumab benefit are limited. The chemokines CXCL9 and CXCL10 attract CD8 ⁺ T cells into the tumor microenvironment (TME) and are associated with che...

537 Background: There is no evidence regarding the benefit of extended endocrine therapy (eET) beyond 5 years of adjuvant treatment with LHRH agonists (LHRHa) in premenopausal women with node-positive, HR-positive early breast cancer (eBC). Methods: We conducted a retrospective study on two prospectively maintained datasets (Young Women Study and I...

1098 Background: Leucine-rich repeat-containing protein 15 ( LRRC15) has emerged as a potential biomarker and therapeutic target for various cancers due to its high expression in cancer-associated fibroblasts (CAFs) and role in tumor progression. High LRRC15 expression is associated with poor prognosis in TNBC. This study aims to define the multiom...

Breast cancer (BC) is a leading cause of death among women, with approximately 30% HER2-positive (HER2+). Although HER2-targeted therapies have improved outcomes for patients with HER2+ metastatic breast cancer (mBC), clinical challenges and prognostic variability remain. Tumor-infiltrating lymphocytes (TILs) have emerged as prognostic and predicti...

Background Comprehensive genomic profiling (CGP) is being increasingly adopted in clinical practice to guide the use of molecularly guided treatment options (MGTOs). To optimize the integration of MGTOs in routine cancer care, molecular tumour boards (MTBs) have been established. Limited data are available to address the clinical value of implement...

Background In patients with phyllodes tumors of the breast, the presence of mediator of RNA polymerase II transcription subunit 12 homolog mutations (MED12m) and a history of previous fibroadenoma may predict better outcomes. To aid in the prognostication of malignant phyllodes tumors of the breast (B-MPT), we assessed the prognostic value of fibro...

Importance Endocrine therapy (ET) combined with cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) agents is the standard first-line treatment for patients with hormone receptor–positive, ERBB2 (formerly HER2 or HER2/neu )–negative metastatic breast cancer. However, optimal therapy after tumor progression to ET plus CDK4/6i remains unclear. Objective...

Introduction: The PI3K pathway is crucial in breast cancer (BC), influencing cell survival, growth, and metabolism, with AKT playing a central role in treatment resistance. This pathway's involvement in breast carcinogenesis and its link to treatment resistance underscores the significance of targeting it in BC therapy. PI3K-pathway inhibitors off...

PURPOSE The use of social media is transforming physician-patient communication, mainly in the field of medical oncology. The pattern of social media use by medical oncologists is poorly studied. Therefore, we developed a survey to understand the preferences, experiences, opinions, and expectations of Italian medical oncologists and oncology fellow...

Antibody–drug conjugates (ADCs) have emerged as a transformative approach in cancer therapy by enhancing tumor targeting and minimizing systemic toxicity compared to traditional chemotherapy. Initially developed with chemotherapy agents as payloads, ADCs have now incorporated alternative payloads, such as immune-stimulating agents, natural toxins,...

PURPOSE Trimodal therapy (TMT) is the standard treatment for patients with nonmetastatic inflammatory breast cancer (IBC). TMT consists of neoadjuvant systemic therapy, modified radical mastectomy (MRM), and postmastectomy radiation therapy. Although broadly considered the best approach for IBC, in the United States, only a third of patients receiv...

Background: Early-phase clinical trials offer a unique opportunity for patients with cancer. These trials often mandate biopsies to collect tumor tissue for research purposes, requiring patients to undergo invasive procedures. Some trials mandate molecular prescreening, but the success of these analyses relies on the quality and quantity of the tes...

Background Patients with a germline BRCA pathogenic variant (gBRCA-PV) and advanced high grade ovarian carcinoma (aHGOC) experience higher hematologic adverse events (HAEs) when receiving platinum salts and ionizing radiations, compared to non-carriers, due to a possible higher susceptibility of the hemopoietic stem cells to DNA targeting agents. H...

Geneva, Switzerland, offered a platform for strengthening discussions in global oncology and highlighting the latest advances in cancer control. The aim of the conference is to bring together health experts from around the world to foster an environment of learning and collaboration. While UICC provides several travel grants, the choice of location...

Geneva, Switzerland, offered a platform for strengthening discussions in global oncology and highlighting the latest advances in cancer control. The aim of the conference is to bring together health experts from around the world to foster an environment of learning and collaboration. While UICC provides several travel grants, the choice of location...

Purpose Comprehensive genomic profiling is becoming increasingly important in the management of patients with metastatic breast cancer (mBC). Real-world clinical outcomes from applying molecular tumor boards (MTBs) recommendations in this context remain limited. Accordingly, we conducted a retrospective, single-institution analysis to evaluate the...

Breast cancer (BC) is a leading cause of death among women, with approximately 30% HER2-positive (HER2+). Although HER2-targeted therapies have improved outcomes for patients with HER2+ metastatic breast cancer (mBC), significant clinical challenges and prognostic variability remain. Tumor-infiltrating lymphocytes (TILs) have emerged as prognostic...

Introduction: Novel compounds have entered the triple-negative breast cancer (TNBC) treatment algorithm, namely immune checkpoints inhibitors (ICIs), PARP inhibitors and antibody-drug conjugates (ADCs). The optimization of treatment efficacy can be enhanced with the use of combination treatments, and the incorporation of novel compounds. In this r...

Background Somatic genetic alterations of the estrogen receptor 1 gene (ESR1) are enriched in endocrine therapy-resistant, estrogen receptor-positive (ER+) metastatic breast cancer (mBC). Herein, we investigated and compared the clinical and genomic landscape of ESR1-mutant (ESR1MUT) and ESR1 wild type (ESR1WT) ER+/ human epidermal growth factor re...

Objective This study analyzes the development, benefits, trial evidence, and price of new breast cancer drugs with US Food and Drug Administration (FDA) approval. Methods We identified 26 drugs with 42 FDA-approved indications for early and metastatic breast cancer (2000–2023). Data were collected from FDA labels, clinicaltrials.gov, and Medicare...

For patients with hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (HR+/HER2−) metastatic breast cancer (mBC) progressed on first-line endocrine therapy plus a cyclin-dependent kinase 4 and 6 inhibitor (CDK4/6i), fulvestrant, a selective estrogen receptor degrader (SERD) administered intramuscularly, represented th...

The emergence of predatory oncology journals represents a significant threat to research integrity. Distance-education approaches to inform oncologists about this risk is promising and effective, particularly for LMICs, as it offers flexibility and affordability.

Background Among patients with advanced high-grade ovarian carcinoma (aHGOC) treated with poly (ADP-ribose) polymerase (PARP) inhibitors (PARPis), the presence of a germline BRCA pathogenic variant (gBRCA-PV) may increase the risk of bone marrow mutagenesis resulting in postcytotoxic therapy myelodysplastic neoplasms (MDS-pCT) or acute myeloid leuk...

Purpose of review Patients with advanced breast cancer (aBC) treated with PARP inhibitors (PARPi) can eventually experience disease progression for emerging treatment resistance. This review aims to depict the treatment the molecular landscape, and the innovative therapies for patients with PARPi-resistant BRCA-mutated aBC. Recent findings No spec...

Objectives The UK’s withdrawal from the European Union (a political movement known as ‘Brexit’) incited concern both in the public and private sector about the future of drug development and the clinical trial landscape in the UK. This study evaluates trends in the initiation of phase III clinical trials that evaluated systemic anticancer treatment...

Background Carcinoma of unknown primary (CUP) with a gastrointestinal profile is categorized by the European Society of Medical Oncology (ESMO) guidelines into favorable and unfavorable subsets. Favorable CUPs benefit from site-specific chemotherapy (CT), while the optimal treatment for unfavorable CUPs is still undefined. Materials and methods We...

Purpose of review Significant advancements have been made in treating metastatic breast cancer (MBC) with antibody drug conjugates (ADCs). However, due to the development of resistance, patients experience disease progression. The aim of this review is to summarize current evidence on ADCs sequencing strategies and combination approaches in the tre...

Background Interstitial lung disease (ILD) encompasses a heterogeneous group of disorders sharing pathophysiological inflammatory mechanisms, leading to parenchymal distortions. The prevalence of ILD with new cancer drugs is underreported: the identification of potential determinants is priority. Materials and methods ILDE is a retrospective study...

Purpose of review The purpose of this review is to provide a comprehensive overview of human epidermal growth factor receptor 2 (HER2) genomic tests, particularly focusing on the most recent developments and looking at the future prospects of this field, yet to be thoroughly explored. Recent findings HER2DX is a multifeatured assay, retrospectivel...

Background Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature...

Breast cancer presents diverse molecular subtypes affecting treatment strategies. Human epidermal growth factor receptor 2 (HER2)-low, hormone receptor-positive (HR+) breast cancer poses a challenge due to limited targeted therapies. Current neoadjuvant treatment primarily utilizes chemotherapy, with conflicting results regarding efficacy in patien...

Antibody–drug conjugates (ADCs) are anticancer agents with the capacity to selectively deliver their payloads to cancer cells. Antibody–drug conjugates consist of a monoclonal antibody backbone connected by a linker to cytotoxic payloads. Antibody–drug conjugate effect occurs either by directly targeting cancer cells via membrane antigen or through...

Antibody-drug conjugates (ADCs) have reshaped the cancer treatment landscape across a variety of different tumor types. ADCs' peculiar pharmacologic design combines the cytotoxic properties of chemotherapeutic agents with the selectivity of targeted therapies. At present, the approval of many ADCs used in clinical practice has not always been bioma...

e23522 Background: Malignant phyllodes tumors of the breast (B-MPT) are supposed to arise de novo or to derive from a fibroadenoma/benign phyllodes tumor ("secondary"), through a MED12-dependent pathway. Secondary B-MPTs may be associated to better outcomes: both the history of previous fibroadenomas and the presence of MED12 mutations were demonst...

e24009 Background: Among immunoncology agents (IO), immune checkpoint inhibitors are the most used, demonstrating survival benefit across multiple cancer types. Adverse events are often reported with IO; cardiotoxicity is rare, but potentially fatal. CAVIO study evaluated the occurrence of cardiovascular events (CVE) in patients receiving IO in pha...

9002 Background: Conflicts of interest (COI) between oncologists and the pharmaceutical industry might considerably influence how the presentation of the research results is delivered, impacting treatment decisions, and policy-making.While there are regulations on reporting COI in high-income countries (HICs), little is known about their reporting...

Transgender and gender-diverse (TGD) individuals face an elevated risk of cancer in comparison with the general population. This increased risk is primarily attributed to an imbalanced exposure to modifiable risk factors and a limited adherence to cancer screening programmes, stemming from historical social and economic marginalisation. Consequentl...

PURPOSE Open-access publishing expanded opportunities to give visibility to research results but was accompanied by the proliferation of predatory journals (PJos) that offer expedited publishing but potentially compromise the integrity of research and peer review. To our knowledge, to date, there is no comprehensive global study on the impact of PJ...

Effective risk assessment in early breast cancer is essential for informed clinical decision-making, yet consensus on defining risk categories remains challenging. This paper explores evolving approaches in risk stratification, encompassing histopathological, immunohistochemical, and molecular biomarkers alongside cutting-edge artificial intelligen...

Introduction: Treatment decisions for ER+/HER2- mBC may be influenced by pt knowledge about treatment side effects, which is shaped by pt-provider communication. We conducted a survey of pts with ER+/HER2- mBC to better understand pt expectations and experiences of treatment toxicities, the extent they were discussed by the pts’ medical team (MT),...

Background: Inflammatory breast cancer (IBC) is an aggressive clinical presentation of breast cancer (BC). Immune checkpoint inhibitors (ICIs) combined with chemotherapy provided an overall survival (OS) benefit in the metastatic setting and an even-free survival (EFS) benefit in patients (pts) with early triple-negative (TN) BC, respectively. Pati...

Background: Metaplastic Breast Cancer (MBC) is rare (0.2-5%), aggressive form of BC characterized by chemotherapy resistance and has worse outcomes in comparison to other BC subtypes. Resistance to chemotherapeutic agents is related to defects in intact intrinsic apoptosis pathway and the BCL2 family of proteins are the central regulators of this p...

Introduction: Treatment toxicity and side effects may be underreported (Basu Roy. J Thorac Oncol 2018:13:1815-17) and can negatively impact QoL. As such toxicities can influence pts’ treatment decisions, we surveyed pts with ER+/HER2- mBC to better understand the impact and patient reporting accuracy of treatment toxicities/side effects. Methods: T...