IRCCS National Cancer Institute Foundation

The IRCSS Foundation, the National Cancer Institute Foundation (INT), as the first Italian Comprehensive Cancer Centre, pursues its objectives as a public oncological IRCCS through a wide range of healthcare and research activities.

INT confirms itself as a national and international reference center in cancer treatment and research, both for the most common cancers and rarer ones, such as sarcomas, head and neck cancers, and pediatric cancers.

INT has more than 18,000 hospitalizations a year, of which about 25% are for patients coming from outside the Regione Lombardia.

Innovative therapies (immunotherapy, new technologies of radiotherapy and sequencing (NGS), also applied in diagnostics) are provided to patients through different modalities, including participation in sponsored and non-profit studies, in the very early phase (Phase I).

INT research is fulfilled with scientific structures and programs ranging from basic biological research to clinical and epidemiological health research, privileging a translational approach, through which new findings can be quickly transferred from the research domain to the “patient’s bed.”

INT has approximately 600 active clinical trials, of which 60% are experimental (Clinical Trials) with an enrollment of around 25,000 cases per year; in 2016, 689 scientific articles were published, 280 with INT author as first or last author.

At the international level, INT participates in countless research networks and more than 12 cancer research organizations. Moreover, INT is a coordinator of the Joint Action on Rare Cancers, a project funded by the European Commission, and is joining the Cancer Core Europe Consortium, which is the network of excellence that includes the best European Comprehensive Cancer Centers.

Oncology Reference Center

The Oncology Reference Center of Aviano (CRO) opened in 1984 and was recognized in 1990 as a Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) by the Italian Ministry of Health.

It is dedicated to cancer care and research in all phases: from prevention to diagnosis, treatment to rehabilitation care, having the patient and their family always at the center of its attention. CRO financial support is guaranteed by Friuli Venezia Giulia (FVG), the MdS and various competitive grants, particularly AIRC.

The clinic of the CRO includes innovative medical oncology treatments (precision medicine, immunotherapy, and autologous bone marrow transplantation), general, breast and gynecological surgery, and advanced radiotherapy, both curative and palliative. A Youth Area is dedicated to adolescents with cancer. In 2018, the CRO staff was 653 (including 109 physicians) and 90 fellows/contractors. Further, 11,200 patients visited, 2,955 new cases were diagnosed, and 7,321 patients treated, about half from outside the region.

Research, primarily clinical and translational, mainly concerns: 1) cancer genetics and biology, 2) epidemiology and prevention, 3) hemolymphopoietic neoplasms, 4) solid tumours, and 5) tumours associated with infectious agents. In 2018, the CRO published 268 peer-reviewed articles, whose 10% were in high-impact journals and organized 164 in-house refresher courses and 12 scientific conferences. The institute also manages the FVG Tumor Registry and a Biobank of approximately 170,000 serum and tissue samples from over 7,000 cancer patients and healthy subjects. The CRO Library assists both staff and patients and their families through numerous informative and educational initiatives.

Collaborations with the Universities of Trieste, Udine and other Universities make possible the presence at the CRO of an average of 30 trainees in medical oncology and other relevant disciplines and 30 Post-Doc Fellow. Young researchers can be housed in the adjacent campus, which hosts teaching facilities and the FVG Regional Ethics Committee. The institute pursues with conviction the sharing of knowledge and projects with national and international networks, particularly Alliance Against Cancer, OECI – Organization of European Cancer Institutes, BBMRI – Network of Italian Biobanks and IARC/WHO.

The CRO is always focused on innovation, including experimentation on new organizational and social health models. It has technological platforms with state-of-the-art equipment for clinical and research: multispectral cytofluorimetry/cell sorting, NGS sequencing, gene expression and microRNA analysis, epigenetics, microscopy and imaging techniques, pre-clinical in vivo and in vitro models, pharmacogenomics, nanomedicine, and spectroscopy. Also, well-equipped are imaging diagnostics (CT scanners, 3-T MR, PET-CT, SPECT-CT) and radiotherapy (IMRT, VMAT, Tomotherapy, IORT) that allow for more effective and less toxic treatment plans. The CRO is also gearing up for proton therapy and cellular therapies.

In 2018, 200 clinical-experimental protocols (profit and non-profit) were active in collaboration with pharmaceutical and diagnostic industries. Participation in POR programs activated 12 projects to create new products with small/medium-sized companies. Ideas from CRO scientists have led to 18 patents and four spin-offs. The Institute’s Technology Transfer Office is an active part of the NETVAL and ASTP-PROTON networks, bridges between public research and industry, and is supported by a grant from the Italian Patent and Trademark Office (UIBM-MISE). In 2017, the Campus CRO hosted the first edition of Technology Transfer School for researchers from the 52 IRCCS.

IRCSS San Martino Ist

The San Martino Hospital has always been a health reference point. It is an institution with five centuries of history and represents the primary health ‘hub’ in Liguria, attracting patients from the metropolitan area, from the inside of Liguria and outside the region.

After the University Hospital San Martino and the scientific Tumor Institute merged, both in the same city, on 1 September 2021, the University Hospital IRCCS San Martino IST National Institute for the Cancer Research was established, specializing in haemato-oncology.

With Regional Law no. 29 of 28/12/2017, the Institute took the name “IRCCS Polyclinic Hospital San Martino.” On 5 March 2018, the Institute also obtained recognition for a second discipline, “Neuroscience.”

The Institute houses the didactic centre of the Medical and Pharmaceutical Sciences School, which includes the Degree Course in Medicine and Surgery, Postgraduate Diplomas, Research Doctorates, Level I and II Masters and Degree Courses in the health professions.

The hospital is a city within a city, with around five thousand employees and 35 hectares of land on which the complex extends, crossed by 12 km of avenues. The hospital is easily reachable from the thoroughfare and railways and is even served by urban and suburban public transport.

The Institute provides diagnosis and treatment of illnesses on an inpatient basis according to macro-activities: hospitalization, day hospital, day surgery, operating blocks, outpatient and surgical clinics, diagnostic services, support services, complex outpatient services, outpatient day services.

In addition to offering all principal specialistic medical and surgical services, Polyclinic San Martino retains medical features that place it at the forefront in the diagnosis and treatment of major haemato-oncological diseases, with a range of activities from acute leukemia to bone marrow transplants and solid tumours classified as “big-killers.” A large number of cases gives the resources to clinical studies on chemotherapeutic drugs and also on new molecularly targeted drugs. In addition, the large number of cases enables translational studies to be carried out on the ‘mechanisms of oncological disease’ on material from patients investigated in vitro in the laboratory using the latest technology.

IRCSS Giovanni Paolo II

“Giovanni Paolo II” is a Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), a legal entity of public law, of national relevance, not transformed into a foundation, confirmed by Ministerial Decree May 30, 2014, published in the Official Gazette No. 140 of 19-6-2014, in the disciplinary specialization Oncology.

The Institute stands as a center of excellence for pre-clinical, translational, and clinical research and assistance. Inseparability, reciprocity, and the functional continuum between clinical and research constitute an added value of undoubtedly positive significance, earning the certification as a Clinical Cancer Center (February 12, 2015), following the provisions of the Organization of European Cancer Institutes (OECI).

It is equipped with 109 beds to treat all adult oncological diseases.

It employs 110 researchers (2018).

The Institute is equipped with several laboratories dedicated explicitly to research (Invasion and Metastasis, Applied Molecular Genetics, Clinical and Pre-clinical Pharmacology, Functional Bio-morphology).

It is also equipped with a GMP – Facility (Advanced Cellular Therapy Center) and a Biobank representing the infrastructure dedicated to the CRYOPRESERVATION and HANDLING of biological tissue, cellular and serum samples used following national and international guidelines and for scientific research purposes.

Among the technological and clinical equipment in the Institute, the UMACA Laboratory and a Hybrid Operating Room designed for the most modern radiotherapy-interventional applications stand out.

National Cancer Institute Pascale Foundation

The National Institute for Tumors “Pascale Foundation” is a Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) founded in 1933 by Senator Giovanni Pascale. It is an institution of national prestige with autonomy and legal entity, which, according to standards of excellence, pursues research objectives, mainly clinical and translational, in the biomedical field and the organization and management of health services and hospitalization and treatment of high specialty.

It represents the most prominent institution in Southern Italy and is the coordinator of the Campania Oncology Network established by DCA n°98/2016; it is also the reference center for the national oncology network.

The pursuit of the Institute is cancer prevention, diagnosis and treatment, and related research. It is a response for citizens to health needs, both from the perspective of recovery and maintenance.

The main feature that stands at the base of the mission is the ability to transfer research results and innovation to daily clinical activity. Indeed, research projects are strongly oriented to a translational purpose, assuming a continuous exchange of information between laboratory and clinical activity.

The centrality of the patient within the healthcare pathway includes ability to listen to the specific health needs expressed by the community and is the principle for the strategic choices of the Institute. The primary objective is to achieve excellence in preventing, diagnosing, and treating cancer diseases through clinical research and technological and management innovation.

The pre-clinical and clinical research conducted in the Institute is developed in four main macro-areas:

Macro-area 1 – Prevention and Risk Factors in Neoplastic Disease

Macro-area 2 – Tumor Markers and Innovative Diagnostic Procedures

Macro-area 3 – Integrated Treatments in Oncology

Macro-area 4 – Innovative Therapeutic Strategies in advanced stages of disease

Furthermore, the Institute bases its research and treatment of cancer pathologies on the following reference values:

centralization of the citizen-user concerning the organization of health services: the citizen figure is an essential element around which business decisions are developed;

flexibility of planning in alignment with the requests of its stakeholders: health care activities, by their nature, are not always standardized, allow maximum planning flexibility that can take into account the constant needs that come from users;

accessibility of services and health information: the Service Charter and Welcome Card (distributed by the URP) supports citizens in accessing health services. These traditional methods are also supported by the institutional web portal where all essential information is available;

certainty of health service quality and professionalism: the primary objective of the Institute is to guarantee citizen service quality offered as well as professionalism of health, administrative and technical resources that work with dedication and constancy;

User participation in the planning and monitoring of activities: the individual user participates in the evaluation of services provided by the Institute, with the results utilized for strategic and operational planning of the entire structure.

For some years, in the ongoing process of reviewing its role and functions, the Institute has been aiming to improve transparency towards stakeholders and promote privacy.

Healthcare is one of the most delicate sectors among those that must deal with the complex problems posed by privacy legislation, which has become a fundamental element in improving the quality of healthcare service.

In this context, the “Privacy Regulation,” was adopted as its correct application can only guarantee the dignity of patients.

Regina Elena Institute (IRE)

The Regina Elena National Cancer Institute in Rome (IRE) has been operating since 1933 in the most advanced research and cancer therapy.

The IRE is involved in national and international research, in biomolecular and instrumental diagnostics, in epidemiology and early diagnostics, and it implements standard or innovative protocols for the treatment and rehabilitation of cancer patients. All activities are characterized by intense integration between the clinical and experimental areas. The Institute maintains a high-quality level and is ISO 9001/2015 certified and, in the European Union, has obtained OECI accreditation as a Comprehensive Cancer Center. The interdepartmental organization ensures a multidisciplinary approach, optimizing and integrating prevention, early diagnosis, and therapy. In this perspective, the Translational Research Groups aim to promote a multidisciplinary and synergistic association between research and the clinic to accomplish translational research with significant clinical relapse in a relatively short time. Each study group includes professionals with different training and experience.

The enhancement in translational research activity has led to the intensification of personalized and precision medicine, a new approach for treating and preventing diseases, which considers the genetic and epigenetic profile of individual cancers, genetic predisposition, environment, and lifestyle of each person. Oncogenomics, Epigenetics, Proteomics and Pharmacogenetics are the tools that support the research in studying, analyzing gene expression profiles, identifying specific alterations relevant to pathogenesis, prognosis, therapy, and the identification of the most favorable pharmacological and/or therapeutic combinations.

The Oncology Biobank for Research Purposes IRE (BBIRE) was established to implement basic, clinical, and translational oncology research. The BBIRE represents a strategic asset and aims to collect, preserve, and distribute human biological material, tissues, and biological fluids, and associated data. At the time of this writing (October 2019), the Oncology Biobank held more than 5,000 cryopreserved samples of tumour tissue fragments and more than 40,000 vials of biological fluids (predominantly serum and plasma) from cancer patients.

In support of precision medicine, the IRE has promoted the following activities: i) Molecular Tumor Board (MTB), a discussion board aimed at identifying cutting-edge personalized therapeutic profiles for the treatment of cancer patients; ii) Immunotherapy Unit, considering the central role of the patient’s immune system in the onset of cancer, IRE has created an Immunotherapy Task Force equipped with a technological platform for multiparameter immunological monitoring in oncological patients before and during immunotherapeutic and radiotherapy treatment in order to identify immunological parameters predictive of response. In addition, a new program has been launched to improve the efficacy of CAR-T in solid tumors; iii) Phase I-II Study Center, which has the strategic goal of bridging the ‘gaps’ between experimental and clinical research, on the one hand, and between clinical research and direct patient care, on the other; iv) innovative therapeutic presides such as proton therapy and Gamma Knife. Moreover, the Institute plays a primary role in the study and treatment of rare adult cancers with over 800 new cases treated each year and has obtained accreditation from the European network EURACAN.

In surgery, the Institute was among the first to introduce laparoscopy and robotics for increasingly conservative interventions and optimize robotic techniques in all districts. An example of this is the Gynecologic Oncology Surgery Unit that performs 85% of the interventions with minimally invasive procedures. The Unit is among the few in Italy and Europe to perform robotic surgery with a single micro-incision of the umbilicus. The operating rooms are high-tech and multimedia. A modern sentinel lymph node analysis technique for breast cancer and the extensive use of laparoscopic procedures are always used to safeguard patient life quality and ensure the best therapeutic efficacy.

The IRE is equipped with a Skeletal Muscle Tissue Bank, the only one in central and southern Italy, and an ovarian tissue bank, the first public center in Italy.

The IRE is also a regional referral center for digestive endoscopy and familial polyposis, and home care for neurosurgical patients, while it is a national referral center for cancerous epilepsy.

The IRE is also a member of the ‘Union International Contre le Cancer’ (U.I.C.C.), the European Organization for Research and Treatment of Cancer (E.O.R.T.C. – Early ClinicaI Trial Group) and the Italian and European networks for translational research A-IATRIS and EATRIS, respectively