He may be equipped with a microscope rather than a scalpel, but new staff pathologist Massimo D’Apuzzo, M.D., Ph.D, makes decisions that affect surgical and post-surgical treatment every day.
D’Apuzzo arrived at City of Hope in January from Stanford University Medical Center, where he was a neuropathology fellow. He brings both strong basic science training and diagnostic expertise in the most up-do-date methods of evaluating brain tumors.
During surgery, tumor tissue is removed, or resected, by surgeons and then analyzed in the pathology laboratory, where tissue is processed and mounted on a glass slide. On a typical
day, D’Apuzzo assesses dozens of tissue samples from patients.
“Part of my duties also include consultation with surgeons in mid-surgery, when rapid diagnosis is given to help the surgical team assess an ongoing procedure,” he explained.
D’Apuzzo sees a wide variety of tissue at City of Hope. “In addition to frequent breast biopsies and prostate resections, many complex surgical procedures are performed every day, including an increasing number of brain tumor resections,” he said.
D’Apuzzo relies on traditional staining methods to classify cancers, noting, “Histology is still the best way to diagnose a tumor.” Nonetheless, he can deftly discuss molecular approaches that may become more common in the future, such as gene expression profiling of tumor types.
He specializes in the pathology of brain tissue, an expertise recognized by Lawrence Weiss, M.D., chair of the Department of Pathology. “Dr. D’Apuzzo brings strong diagnostic skills in neuropathology and a solid background in general surgical pathology,” Weiss said. “His neuropathology skills bridge a gap in expertise that we had in the Department of Pathology.”
Behnam Badie, M.D., director of the Brain Tumor Program, echoes that sentiment. “We are very pleased to have Dr. D’Apuzzo join our Brain Tumor Program team,” Badie said. “His expertise in clinical neuro-oncology and research interests in brain tumor stem cell biology are great additions to our expanding program at City of Hope.”
Although brain tumors are serious conditions, D’Apuzzo stresses that they are treatable.
“More than 50 distinct types of tumors can occur in the brain, ranging from low-grade lesions, which may be cured by a complete surgical resection, to high-grade, malignant brain tumors, which may require chemotherapy and radiation,” he said. “Understanding the cellular origin and extent of a tumor can greatly aid in determining a course of treatment of the disease.”
D’Apuzzo earned both his doctor of medicine and doctor of philosophy (in immunology) degrees at the University of Bern in his native Switzerland. In 1998, he received postdoctoral training in a neuroscience laboratory at Caltech and developed a method to visualize individual neurons in mouse brains by infecting them with viruses carrying fluorescent markers.
Then, as a pathology research fellow and resident at Massachusetts General Hospital, he collaborated on papers focusing on the activity of a tumor suppressor protein called cables, whose loss is associated with ovarian cancer.
After moving to Stanford in 2005, D’Apuzzo conducted basic research on both neural stem cells and so-called cancer stem cells in the laboratory of stem cell pioneer Irv Weissman, M.D.
“I am particularly fascinated by the existence of differentiation pathways in brain tumors and I want to identify molecules responsible for such maturation,” he said of his own research interests. “These findings should be helpful in developing new prognostic markers and essential in establishing differentiation therapies in brain tumors.”