Valentina Guarneri

Full Professor

Telefono: +39 0498215291


Programme for Oncology Leaders in Europe
Scuola di Direzione Aziendale Università Bocconi, Milano
Post-graduation degree on "Statistics applied to clinical  problems"
University of Modena and Reggio Emilia
Ph.D. Clinical and Experimental Oncology
University of Modena and Reggio Emilia
1999 - 2003
specialization in medical oncology, 110/110 cum Laude
University of Pisa
Medical Degree, 110/110 cum Laude
University of Pisa
Humanistic Bachelor Degree 60/60, Liceo-Ginnasio GB Niccolini-FD Guerrazzi, Livorno,

October 2014 –onwards
University of Padova
Department of Surgery, Oncology and Gastroenterology
Associate Professor

September 2013-Onwards
Division of Medical Oncology 2,
Istituto Oncologico Veneto IRCCS
Attending Physician, Head of the Translational Research and Innovative Therapy Unit

April 2013-September 2014
University of Padova
Department of Surgery, Oncology and Gastroenterology
Assistant Professor
April-September 2013
Division of Medical Oncology 2,
Istituto Oncologico Veneto IRCCS
Attending Physician,

05/2011 - 31/03/2013
Division of Medical Oncology,
Modena University Hospital,
Coordinator of the Breast Unit

11/2005 - 31/03/2013
Division of Medical Oncology,
University of Modena and Reggio Emilia, Modena
Assistant Professor
Attending Physician, Modena University Hospital

University of Texas MD Anderson Cancer Center, Dept of Breast Medical Oncology
Visiting Assistant Professor

University of Texas MD Anderson Cancer Center, Dept of Breast Medical Oncology

Division of Medical Oncology,
Modena University Hospital,
Attending Physician

Since 2001, Prof. Guarneri is involved in breast cancer clinical and translational research, aimed to evaluate new therapeutic strategies for  a more personalized treatment. The research production from 2001 up to now consists of more than 100 papers published on peer reviewed journal.  The major research accomplishments are:

The evaluation of the prognostic role of pathologic complete remission (pCR) after neoadjuvant chemotherapy in more than 1200 patients treated at the MD Anderson Cancer Center, Houston, TX. This project was conducted during a research period supported by a grant from the Komen Foundation at the Dept. of Breast Medical Oncology. We have demonstrated that pCR is prognostic, independently from the expression of hormone receptor (Guarneri V et al, J Clin Oncol. 2006; 24:1037-1044, PMID: 16505422). This observation was recently confirmed by a meta-analysis on more than  12000 cases.

The study of the dynamic change in the expression of hormone receptor and Her2. We have demonstrated a change in the expression of HR and HER2 from primary tumors to metastatic deposits (Guarneri et al, The Oncologist, 13:838-44, 2008 PMID: 18650259) and the correlation of the change in receptor status with survival (Dieci et al, Ann Oncol. 2013 Jan;24(1):101-8. PMID: 23002281.2013). In the neoadjuvant setting, we have demonstrated that the loss of HER2 expression is more frequent after chemotherapy than after chemotherapy + anti-Her2 agents. (Guarneri et al, Ann Oncol. 2013 Dec;24(12):2990-4. PMID: 24013581)

The generation of a prognostic model based on the study of residual disease after neoadjuvant chemotherapy. We have demonstrated that patients with less than pCR have a different risk of relapse according to Ki67 and nodal status after therapy. (Guarneri V et al,Ann Oncol, 2009)

The  association between PI3KCA mutations and response to letrozole-lapatinib. In a randomized phase II study of neoadjuvant letrozole-lapatinib vs letrozole-placebo, the probability of achieving an objective response in the letrozole-lapatinib arm was higher in the presence of PI3KCA  mutations vs wild type cases. In the letrozole-placebo arm, the objective response rate was not influenced by PI3KCA status. (Guarneri V et al, J Clin Oncol. 2014)

The role of dual anti-Her2 blockade in the neoadjuvant setting. We have demonstrated that the combination of trastuzumab, lapatinib  and chemotherapy significantly increases the rate of pCR as compared to chemotherapy plus either single agent alone in patients with Her2 positive stage II-III breast cancer. (Guarneri V et al, J Clin Oncol, 2012). The biomarker analysis has suggested the potential role of PIK3Ca in predicting response to the dual anti-HER2 blockade (Guarneri V et al, The Oncologist 2015, Guarneri V et al, ESMO 2014; Loible S, Neljudova V, Guarneri V et al, Ann Oncol 2016).

We have recently completed an investigator-driven prospective trial where HER2+/HR+ patients received neoadjuvant treatment with dual Her2 blockade plus hormonal therapy or chemotherapy on the basis of Ki67 modulation after 2 weeks of letrozole.

We have demonstrated that A Ki67 reduction after short term letrozole exposure allows to identify patients achieving a meaningful pCR rate without chemotherapy. Correlative science analyses included the evaluation of  PAM50 intrinsic subtype, tumor infiltrating lymphocytes and PIK3CA mutations. In particular,. PAM50 subtyping further refines our ability to identify a subset of patients for whom chemotherapy can be safely spared.  (Guarneri V et al, Oral Presentation ASCO 2018

1. Darlix A, Griguolo G, Thezenas S, Kantelhardt E, Thomssen C, Dieci MV, Miglietta F, Conte P, Braccini AL, Ferrero JM, Bailleux C, Jacot W, Guarneri V. Hormone receptors status: a strong determinant of the kinetics of brain metastases occurrence compared with HER2 status in breast cancer. J Neurooncol. 2018 Feb 27. doi: 10.1007/s11060-018-2805-9.

2. Dieci MV, Prat A, Tagliafico E, Paré L, Ficarra G, Bisagni G, Piacentini F, Generali DG, Conte P, Guarneri V. Integrated evaluation of PAM50 subtypes and immune modulation of pCR in HER2-positive breast cancer patients treated with chemotherapy and HER2-targeted agents in the CherLOB trial. Ann Oncol.  2016 Oct;27(10):1867-73.

3. Guarneri V, Dieci MV, FrassoldatiA, Maiorana A, Ficarra G, Bettelli S, Tagliafico E,Bicciato S, GeneraliDG, Cagossi K, BisagniG, Sarti S, Musolino A, Ellis C, Crescenzo R, ConteP. Prospective Biomarker Analysis of the Randomized CHER-LOB Study Evaluating the Dual Anti-HER2 Treatment with Trastuzumab and Lapatinib Plus Chemotherapy as Neoadjuvant Therapy for HER2-Positive Breast Cancer. The Oncologist 2015, 20(9):1001-10

4. Guarneri V, Generali DG, Frassoldati A,  Artioli F, Boni C,  Cavanna L,  Tagliafico E, Maiorana A, Bottini A, Cagossi K,  Bisagni G, Piacentini F, Ficarra G, Bettelli S, Roncaglia E, Nuzzo S,  Swaby R, Ellis C, Holford C, Conte PF. Double-blind, placebo-controlled, multicenter randomized phase IIb neoadjuvant study of letrozole-lapatinib in postmenopausal hormone receptor-positive, HER2-negative, operable breast cancer. J Clin Oncol, 2014 Apr 1;32(10):1050-7

5. Guarneri V, Dieci MV, Barbieri E, Piacentini F, Omarini C, Ficarra G, Bettelli S, Conte PF. Loss of HER2 positivity and prognosis after neoadjuvant therapy in HER2 positive breast cancer patients. Ann Oncol, 2013 Dec;24(12):2990-4.

6. Guarneri V, Frassoldati A, Bottini A, Cagossi K, Bisagni G, Sarti S, Ravaioli A, Cavanna L, Giardina G, Musolino A, Untch M, Orlando L, Artioli F, Boni C, Generali DG, Serra P, Bagnalasta M, Marini L, Piacentini F, D’Amico R, Conte PF. Preoperative chemotherapy plus trastuzumab, lapatinib or both in HER2 positive operable breast cancer: results of the randomized phase II CHER-LOB study. J Clin Oncol, 2012 Jun 1;30(16):1989-95

7. Guarneri V, Piacentini F,  Ficarra G , Frassoldati A, D’Amico R, Giovannelli S, Maiorana A , Jovic G, Conte PF. A prognostic model based on nodal status and Ki-67 predicts the risk of recurrence and death in breast cancer patients with residual disease after preoperative chemotherapy. Ann Oncol, 2009 Jul;20(7):1193-8

8. Guarneri V, Frassoldati A, Ficarra G, Puglisi F, Andreetta C, Michelotti  A, Cresti N,  Boni C, Bisagni G, Berardi R, Battelli N, Santoro A, Banna G, Bottini A, Di Blasio B, Maiorana A, Piacentini F, Giovannelli S, Jovic G, Conte PF. Phase II, randomized trial of preoperative epirubicin-paclitaxel +/- gefitinib with biomarker evaluation in operable breast cancer. Breast Cancer Res Treat, 110:127-34, 2008

9. Guarneri V, Lenihan DJ, Valero V, Durand JB, Broglio K, Hess KR, Michaud LB, Gonzalez-Angulo AM, Hortobagyi GN, Esteva FJ. Long term cardiac tolerability of trastuzumab in metastatic breast cancer: the M.D. Anderson Cancer Center experience. J Clin Oncol 2006, 24: 4107-15

10. Guarneri V, Broglio K, Kau S, Cristofanilli M, Buzdar A U, Valero V, Buchholz T, Meric F, Middleton L, Hortobagyi G N, Gonzalez-Angulo A M: Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors. J Clin Oncol. 2006; 24:1037-1044

Grant AIRC “PIK3CA mutations/PTEN loss and infiltrating tumor lymphocytes to personalize therapy in HER2+ early breast cancer” MFAG 2014 Id.15938

Progetto Ricerca Finalizzata GR-2013-02356771 “Challenging the role of chemotherapy in HER2 positive early breast cancer: PI3KCA pathways alteration and response to neoadjuvant pertuzumab-trastuzumab plus letrozole