Gianni Bonadonna: A Personal Remembrance

The field of medical oncology has lost one of its heroes. Gianni Bonadonna died on September 6, 2015. Those of us who had the opportunity to know him and interact with him professionally remember a very intelligent, elegantly stylish, Italian gentleman who became an international figure in his field as a result of leading several important clinical trials that changed our approach to the treatment of those particular diseases. Gianni was born in 1934 and was educated in Milan prior to obtaining fellowship training at Memorial Hospital in New York. He returned to the Istituto Tumori in Milan where he became Director of the Division of Medical Oncology in 1976. In 1991, he was appointed Head of the Department of Cancer Medicine in the same institution and Associate Professor at the School of Hematology of the University in Milan. We got to know him well when he came back to the United States on a visit to the National Cancer Institute (NCI) in 1969 to investigate the possibility of using adjuvant combination chemotherapy for breast cancer. At that time, our team in the Medicine Branch at the NCI was testing a new regimen, cyclophosphamide, methotrexate, and fluorouracil, for advanced, previously untreated breast cancer. The results were gratifyingly positive for a time when only single agents, 5-fluorouracil or melphalan, were the most common treatment. The data were presented to Gianni with the view that postoperative combination chemotherapy might be an effective way of preventing relapse. The cancer centers and groups in the U.S. at the time were hesitant about using combination chemotherapy in an adjuvant situation. Gianni agreed to undertake a randomized trial in node-positive patients compared with follow-up alone. With NCI support, that successful trial was reported in the New England Journal of Medicine in 1976 in a now-famous paper that vaulted Gianni Bonadonna to fame in the realm of medical oncology. There followed a new and revolutionary approach to breast cancer using various new active agents as adjuvant treatment. The other area where we shared a common interest was the combination chemotherapy for lymphoma, especially Hodgkin lymphoma. Gianni conceived of a regimen containing drugs not cross-resistant to the NCI regimen, MOPP, namely ABVD, as a salvage regimen. It soon was shown to be a less toxic initial therapy with equivalent effectiveness to MOPP. ABVD remains the standard to this day. Twenty years ago, Gianni suffered a near-fatal stoke that left him severely debilitated. A lesser man might have given up. His response was a profile in courage. In 1999, he founded the Fondazione Michelangelo, of which he served as president, and he continued to make an impact in the field of medical oncology through lectures, a medical oncology textbook, and books on prominent personages in medical history. He loved music, and it was a source of comfort to him after his stroke. Beethoven was his favorite composer (the Eroica symphony a particular favorite), but Puccini touched his Italian soul. He was a collector of ancient Greek statues, Japanese armor, and a variety of interesting objets d’art. In short, he was a renaissance man. Those of us who knew Gianni will sorely miss his intellect, clinical investigative acumen, and charm. He leaves his wife, Mimma, and two children, Stefania and Davide, and a host of colleagues and trainees who occupy leadership positions in Italian medical centers. He was respected and admired by all who knew him. George P. Canellos Vincent T. DeVita Gianni Bonadonna Gianni Bonadonna, center, in his heyday in 1986 at an American Association for Cancer Research meeting, having a good laugh with Vince DeVita and the late Hinda Rosenthal on the occasion of the annual Rosenthal lecture. Gianni Bonadonna in 2005 with George Canellos. He continued to make an impact on the field after his stroke. Gianni Bonadonna with Vince DeVita.