Interview with Dr. Giuseppe Curigliano

Dr Giuseppe Curigliano

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We had the pleasure of interviewing BIG’s Executive Board member Dr. Giuseppe Curigliano, head of the Clinical Division of Early Drug Development at Milan’s European Institute of Oncology and a Professor of Medical Oncology at the University of Milan. Dr Curigliano will be the ESMO President 2027-2028 and will join the ESMO Executive Board on 1 January 2025 as President-Elect.

During this interview, Dr. Giuseppe Curigliano offered his insights on the future of breast cancer research and the role that the Breast International Group (BIG) plays in it.

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Dr Curigliano, can you tell us about your professional background and experience and what motivated you to apply and serve on the BIG Executive Board (EB)?

I am Full Professor of Medical Oncology at the University of Milano and I lead the Clinical Division of Early Drug Development at the European Institute of Oncology, Milano, Italy. I am an expert in the field of drug development in solid tumours, with a specific interest in breast cancer. After lab experience in the United States, working on immunology of cancer, and since 2001, I have been a tenure-track and full-time cancer specialist at the European Institute of Oncology – one of the world’s leading cancer-research institutes and the premier Cancer Center in Italy, third in Europe and 12th globally. I worked in the International Breast Cancer Study Group (IBCSG) when Aron Goldhirsch was the Scientific Chair and, on the recommendation of the late Professor Hans-Jörg Senn, I picked up his baton in the scientific co-coordination of the St. Gallen Consensus Conference on early breast cancer treatment. I also served as Co-Chair of the IMPAKT breast cancer meeting, founded by Professors  Martine Piccart and the late José Baselga, and which was held annually between 2009 and 2017. I also served with the European Society for Medical Oncology (ESMO) as scientific co-chair of the first ESMO Breast Congress. I served as Chair of the Clinical Practice Guidelines Committee of ESMO and am now President-Elect of the society.

Several reasons motivated me to apply and serve on the BIG Executive Board:

  1. Passion for advancing breast cancer research: Joining the Executive Board of BIG provides a unique opportunity to contribute to the advancement of scientific knowledge and breakthroughs in breast cancer.
  2. Global collaborations and networking: This global networking opportunity can foster valuable partnerships to drive innovative research and other collaborative initiatives.
  3. Commitment to bridging international collaborations: BIG is a global organisation, and I recognise the importance of fostering collaborations across different countries and regions to address the global challenges of breast cancer. In a few words, BIG is the place to think big in improving the outcomes of breast cancer patients.

What specific expertise do you believe you can contribute to both BIG EB and the overall organisation?

I believe the first contribution I can provide to BIG is to serve. I can serve throught my medical and scientific experience in guiding research priorities, fostering clinical trial proposals, and ensuring that the organisation stays abreast of the latest advancements in the field. The implementation of successful research projects should focus on the unmet need of patients, and  rely on the energy of the next generation of young investigators. My global network can facilitate collaborations with researchers, institutions, and organisations worldwide. This can enhance BIG’s global reach, foster partnerships, and facilitate the exchange of knowledge and resources.

Please cite some elements that you find critical for the continued success of BIG in the next decade?

There are three critical elements that could be vital for the continued success of BIG in the next decade:

  • Innovative research and clinical trials: Continuously driving innovative and impactful research, as well as conducting well-designed clinical trials, will be crucial for BIG’s success. The organisation must remain at the forefront of breast cancer research, exploring novel treatment approaches, identifying biomarkers, and investigating potential therapeutic targets. Investing in cutting-edge technology and methodologies can enhance the quality and relevance of research, leading to better treatment options and improved outcomes for breast cancer patients.
  • Investing in the young generation: This is crucial to guarantee the future of BIG for several compelling reasons:
    1. Continuity and sustainability: The young generation represents the future leaders, researchers, and professionals who will carry on the legacy of BIG. By investing in their development, we ensure a continuous influx of fresh perspectives, innovative ideas, and enthusiasm, which are essential for the organisation’s sustainability and long-term success.
    2. Innovative thinking and research: Young minds often bring forth a unique perspective and are more open to exploring innovative approaches.
    3. Advancement of technology and data analytics: The young generation is often more adept at leveraging technology and data analytics.
    4. Nurturing a culture of innovation: Investing in the young generation sends a strong message about BIG’s commitment to fostering a culture of innovation and continuous improvement. It motivates the entire organisation to embrace change, adapt to evolving challenges, and strive for excellence in breast cancer research and patient care.
  • Patient-centric approach and advocacy: Placing the needs and well-being of breast cancer patients at the core of their initiatives is crucial for BIG’s continued success. Ensuring patient involvement and engagement in research planning, design, and implementation can lead to research that is more relevant and meaningful for patients. Advocating for patient access to innovative treatments, supportive care, and resources will further reinforce BIG’s impact on breast cancer care globally.

What values do you believe are essential to ensure a positive and successful future for BIG?

BIG has a long tradition. Since its creation, BIG has functioned as a ‘consortium of consortia’. Through BIG, groups draw on combined resources to reduce the wasteful duplication of efforts and to achieve results in breast cancer research, impossible for any individual group in a comparable period of time. Some values, in my opinion, are essential:

  • Excellence and quality: Striving for excellence and maintaining the highest quality standards in research, clinical trials, and patient care should be a fundamental value for BIG.
  • Patient-centric approach: Putting breast cancer patients at the center of all activities is paramount for BIG’s positive impact. Ensuring that research and treatment decisions are guided by patient needs, preferences, and experiences helps deliver more personalised and effective breast cancer care.

Innovation and adaptability: Embracing innovation and being adaptable to advancements in science, technology, and healthcare are critical to staying at the forefront of breast cancer research. BIG must continuously seek new approaches, explore novel therapies, and adapt its strategies to address evolving challenges in the field.

What are the biggest challenges currently faced by all stakeholders of the breast cancer research area? How do you think BIG can play a significant role in this context?

The first challenge will be the essential role of academic independence in early breast cancer clinical trials. The nature of adjuvant trials is crucial – studies need to be large-scale to explore often small differences in outcomes, and should increasingly be tailored to certain groups and followed up properly. These trials require a lot of resources and we need to establish a new agreement between industry and academia that has patients as guarantors. The interests of patients may not be best served if a number of issues are not addressed. These include the need to secure funding for translational work and follow-up beyond commercial implementation. In my opinion, data and biological samples from patients included in registration trials should be available for consultation and for translational research questions. We need to reinforce the relationship between pharma and academia in this direction. Another challenge is related to the overall regulatory rules on clinical research. Increased bureaucracy, the cost of drugs, lack of healthcare coverage for trial participants, and insurance requirements in some countries are all factors that have made it almost impossible to conduct academic clinical research. BIG can play a significant role in addressing these challenges. Incorporating emerging technologies and biomarkers into clinical trials can improve patient stratification and treatment selection, but may also present challenges in validation and implementation. BIG may also ensure inclusivity and representation of diverse patient groups in clinical trials, as it is essential for generalisability and equitable access to new therapies. BIG can actively work to include underrepresented populations and ensure that trial protocols are relevant to different patient demographics.

Do you think we will see practice-changing results from breast cancer research in the next decade? Which ones?

I can highlight potential areas of breast cancer research that may have practice-changing results in the next decade.

  • Immunotherapy advancements: Immunotherapy has shown promising results in various cancer types, and ongoing research in breast cancer is exploring the potential of immunotherapeutic approaches. Developments in personalised cancer vaccines, adoptive T-cell therapies, and immune checkpoint inhibitors could lead to significant practice-changing results, particularly for certain subtypes of breast cancer.
  • Targeted therapies for specific mutations: Advancements in genomic profiling and understanding breast cancer subtypes may lead to the identification of specific genetic mutations and molecular pathways that can be targeted with precision therapies. Targeted treatments tailored to individual patients’ tumour profiles could revolutionise breast cancer treatment and improve outcomes.
  • Liquid biopsies for monitoring and early detection: Liquid biopsies, which involve analysing circulating tumour DNA and other biomarkers in the blood, hold promise for early cancer detection, monitoring treatment response, and detecting minimal residual disease. The widespread adoption of liquid biopsies in clinical practice could enhance treatment decision-making and patient management.

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