Gianni Bonadonna, MD, was considered the “Father of Italian Oncology,” but his scientific contributions to the field and his generous collegial spirit extended far beyond the shores of his native land. Dr. Bonadonna was at the forefront in the battle to convince the surgical establishment that adjuvant therapy could significantly improve clinical outcomes. He was a scientist’s scientist. He was also a patient’s doctor, having this message for the younger generation of oncologists: “Don’t get too caught up in the deluge of data and statistics. It is time to reconnect with the patient.” Dr. Bonadonna died on September 7, 2015. He was 81.
Dr. Bonadonna was born in 1934 in Milan. An enthusiastic student bent on a career in medicine, he graduated with his medical degree from the University of Milan in 1959. He ventured to America in 1961 to pursue his growing interest in cancer, spending time at Memorial Sloan Kettering Cancer Center in New York. Following this time, he would return to Italy to join the Istituto Nazionale dei Tumori of Milan, where he became Director of the Division of Medical Oncology. It would prove a long-lasting and fruitful tenure.
Paradigm-Shifting Collaboration
One of the most significant debates in oncology took place in the mid-1960s, as the primacy of radical mastectomy was being challenged by pioneering oncologic researchers who resolved to demonstrate the benefits of chemotherapy in breast cancer outcomes. Dr. Bonadonna would play a major role in this lifesaving paradigm shift in breast cancer treatment.
At the National Cancer Institute (NCI), George P. Canellos, MD, and Vincent T. DeVita, Jr, MD, and other investigators had tested various combinations of drugs to treat advanced breast cancer and developed a regimen they felt had great promise: CMF (cyclophosphamide, methotrexate, and fluorouracil). One of their colleagues, Paul S. Carbone, MD, had tried to persuade major U.S. cancer centers to launch a trial of CMF, but it was deemed too risky and they were turned down. Undaunted, Dr. Carbone reached out to a forward-thinking surgeon at the Istituto Nazionale dei Tumori, Umberto Veronesi, MD, who, in turn, sent Dr. Bonadonna to the NCI to review the promising data on CMF.
Dr. DeVita told The ASCO Post about Dr. Bonadonna’s elegant arrival at the NCI. “I met Gianni’s plane in the early morning. He walked off in a maroon velour suit without a wrinkle in it and wore the nicest pair of shoes I had ever seen. I thought he must have slept standing up! He spent a week going over the data and modifying CMF for Italian use, and we spent the week going out to dinner together, pleased to find a sort of kinship between us that grew as the years went on. On Gianni’s recommendation, the Istituto Tumori agreed to do the now-famous CMF adjuvant trial published almost 40 years ago in The New England Journal of Medicine, and it vaulted Gianni to medical oncology fame.”
Dr. DeVita continued, “Gianni used the same resources for Hodgkin disease in close consultation with our group—and so began a collaborative arrangement that spun off many benefits to cancer patients everywhere.” Dr. Bonadonna designed and conducted the first clinical trials to explore the use of doxorubicin and developed the doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) protocol, which remains the gold-standard treatment for Hodgkin lymphoma.
Dr. Bonadonna’s work ethic and intellect were renowned, as was his zest for life. Past ASCO President Gabriel N. Hortobagyi, MD, FACP, told The ASCO Post, “Dr. Gianni Bonadonna was one of the world’s most influential cancer researchers, and his work has improved the lives of countless people living with cancer. In addition to being a wonderful physician, clinical investigator, and clinical trialist, Gianni was an avid traveler, a well-known author, and a passionate oncologist, a pioneer with endless curiosity and willingness to take risks. I will always remember him as a warm and loyal friend, with whom I spent many hours of intense discussions about medicine, life, and philosophy. I will miss him dearly.”
ASCO Award in His Honor
In 2007, as a tribute to his contributions to the field of breast cancer research, ASCO instituted the Gianni Bonadonna Breast Cancer Award and Lecture, which is presented annually to a researcher of merit in this discipline. On the news of Dr. Bonadonna’s death, Jay R. Harris, MD, recipient of the award in 2008, remarked to The ASCO Post, “Dr. Bonadonna was a remarkable man and clinical investigator. Most investigators are pleased if they make a major impact in one field. Dr. Bonadonna was noteworthy for making a major impact in two fields: breast cancer and lymphoma. He broke ground in developing adjuvant systemic therapy for breast cancer, which has saved thousands of lives. The concept of using systemic therapy in the absence of disease was radical. He and his team also developed what became the standard therapy for Hodgkin lymphoma—ABVD—which has maintained its importance for decades. He was also a mentor and teacher to legions of oncologists. He leaves a remarkable legacy and will be greatly missed.”
Another awardee and former ASCO President, Nancy E. Davidson, MD, offered her thoughts: “I am saddened by the loss of Gianni Bonadonna. He was a true pioneer in the field of medical oncology. His team at the Istituto Nazionale dei Tumori made seminal contributions to the treatment of Hodgkin lymphoma and early-stage breast cancer, which have stood the test of time. Only someone like Gianni could publish 25- to 30-year follow-ups of clinically meaningful results from randomized clinical trials in these important areas.”
Dr. Davidson added, “I count myself fortunate to be among the recipients [of the Gianni Bonadonna Breast Cancer Award] because Gianni was one of the very best. He set the bar for excellence in clinical and translational research, which has improved the lives of patients around the world.”
Ties That Bind
Dr. Bonadonna authored more than 550 publications in the clinical oncology field, several books on medicine for lay people, and even one book on the Sepoy Rebellion in India. His awards for meritorious service in the field of oncology are too numerous to list. But it was not elegant words on paper or glowing rhetoric that defined Dr. Bonadonna’s legacy. It is the countless thousands of cancer patients whose lives were uplifted by his work and discoveries. And the colleagues he’s left behind.
Dr. DeVita told The ASCO Post that he and Dr. Bonadonna kept in touch over the years, especially after Dr. Bonadonna had a near-fatal stroke in 1995. The two famous oncologists exchanged Christmas greetings this past December. Dr. Bonadonna wrote:
Dear Vince,
The time around the New Year is always a time of memories not always pleasant except for our unbreakable friendship. I am fine, and every day I go to my office and keep on writing. As long as I can, I want to do as Sir Winston Churchill said: “We will never surrender!”
On a cold winter morning in 1975, Dr. Bonadonna flew to Brussels to present the results of his NCI-sponsored CMF trial. The trial’s success was so unexpected that it was greeted by stunned silence in the auditorium. Now, some 4 decades later, the oncology community offers a moment of silence in tribute to one of our finest: Dr. Gianni Bonadonna. ■
