Italy

Website

Wikipedia

OVERVIEW

The Istituto Nazionale Tumori of Milan (INT) is the largest comprehensive cancer center in Italy. The Institute was established in 1928 as a public institution with the name the king: “Istituto Vittorio Emanuele III per lo studio e la cura del cancro.” Since his birth this Institution has aimed to provide the highest standard of patient care, while pursuing preclinical and clinical research. The initial building included 200 beds for cancer patients, operatory rooms, a division of Radiodiagnostic and one of Radiotherapy, but also a Laboratory of Experimental Oncology and a Library. In the first phase of development, before the World war 2, the General Directors were Gaetano Fichera (1880-1935) Surgeon of the University of Pavia , founder of the Journal Tumori in 1910, one of the first publication on cancer in the world, and then Pietro Rondoni (1882-1956) pathologist of the University of Milano

![Picture of the initial Building, 1928]](~/assets-topic/national-tumour-institute/main-image/national-tumour-institute-1928.jpg#center) Picture of the initial Building, 1928]

In 1968 in connection with the old one a new bigger building was inaugurated with 12 floors dedicated to surgical, medical, radiotherapy and radiodiagnostic divisions as well as research laboratories. 460 inpatient beds were activated and more than 400.000 outpatient visits annually provided.

![Picture of the new Building, 1968]](~/assets-topic/national-tumour-institute/main-image/national-tumour-institute-1968.jpg#center) Picture of the new Building, 1968

The first directors of the post war era were Pietro Bucalossi (1905-1992), chief of the Surgical Division of the Institute and Umberto Veronesi (1925-2016), also a director of the same division. Since the beginning of the sixties the high level of diagnostic therapeutic and research activities allowed a functional continuum between clinic and research, as an institutional specificity. The clinical activity was set up with interdisciplinary committees for an homogeneous treatment planning for each neoplasia. Many milestones have been so laid in the history of oncology. The progressive development of the INT can be described as follows. In the sixties:

• Discovery of daunomycin and adriamycin
• Institution of a Clinical Chemotherapy Unit and a Pain Therapy Unit
• The INT becomes WHO referral center for melanoma
• Creation of the first Pediatric Oncology section in Italy and the second in Europe after France
• First reports of the clinical results with adriamycin

In the seventies:

• Creation of the first Endoscopy Unit in Italy
• Demostration of the activity of the new chemotherapy regimens ABVD (adriamycin, vinblastin, bleomycin, dacarbazin) for Hodgkin’s disease
• Set up and management of a Lombardy Tumor Registry
• Demonstration of the activity of the adjuvant regimen CMF(cyclophosphamide, methotrexate, 5-fluorouracil)after radical surgery in breast cancer
• Identification of Tumor associated antigens in experimental animals with the spontaneous development of antitumor immunity
• Herpes virus identification in dysplastic lesions of the uterine cervix
• Activation of the quinquennial Project of the Centro Nazionale delle Ricerche Control of the neoplastic growth” with the involvement of 200 research unit in Italy.

In the eighties:

• Demonstration of the usefulness of conservative surgery in breast cancer
• The INT is proposed as one of the Who referral centres for pain therapy
• Coordination of the WHO melanoma programme -Coordination of the EUROCARE (EUROpean CAncer REgistry-based study on survival and CARE of cancer patients)
• Production of some antitumor monoclonal antibodies -Demonstration that the activation of oncogene KRAS as causal agent in the activation and development of neoplasia
• Demonstration of the escape mechanism to immunological defence through heterogeneous expression of tumour-associated antigens
• First evidence of oncogene rearrangements in solid tumours
• Set up of a registry and biological bank of hereditary tumours

In the nineties:

• Liver transplants with pancreatic islands insertion
• Identification and development of a new series of oral camptotecins
• Identification and molecular cloning of antigens recognized by lymphocytes
• Characterisation of the immunogenicity of neoantigens produced by somatic mutated genes
• Isolation and characterisation of the first thyroid oncogene (RET/PTC1)
• Identification of the oncogene FHIT alteration in lung tumours
• Development of new oral taxanes

In the period 2000-2020:

• Set up of the first Prostate carcinoma Unit in Italy
• Discovery of the mechanism of action of the exosomes of tumoral origin
• International validation of the Milan criteria as a guide-line for liver transplant
• The INT is established as European referral centre for neuroendocrine tumours
• Characterisation of circulating micro RNA in lung, breast, prostate cancer and mesotheliomas
• Identification of genetic polimorfisms associated to the oppioid pain therapy response
• Identification of a cell suppressor subgroup of myeloid derivation in patients with melanoma
• First demonstration of a different genic expression between male and female breast cancer
• Creation of an Unit of Ocular Oncology

In the field of epidemiology this activity started with the Milan University institute of Medical Statistic and Biometrics located within the INT. Initially descriptive epidemiological studies were carried out, while with the development of a Department of Preventive and Predictive Medicine the activity was predominantly oriented to Studies on diet and cancer. At the INT were also developed programmes and projects in the field of public health research. The Institute has been dealing during all his history with direct training on site but also with yearly institutional courses on cancer diagnosis and treatment. In some cases they were formalized through agreements with universities, hosting university specialists. The INT provided also a constant contribution to the organisation of cancer chemotherapy courses of the UICC in developing countries. The teaching activity of the INT was also extended to the South American Countries In parallel to the didactic activity at the INT took place a continuous stimulus to the creation of Oncology departments in the Italian Hospitals. A determinant contribution was also given to the birth and development of the national cancer institutes of Bari and of Aviano. Over the years various initiatives of scientific cooperation were carried out with the USA, Soviet Union, China and other countries. Constant has been the participation of the INT to the EORTC trials, since its foundation The INT also contributed to the birth of the Organization of European Cancer Institutes (OECI). The institutional motto of the INT has been “the Italian Oncology has been born here”.