Michael DiGiovanna, MD, PhD
Professor of Internal Medicine (Medical Oncology)Cards
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Chair, Breast Cancer Tumor Board, Yale Cancer Center
Curriculum Director, Office of Education
Thread Leader, Pharmacology, Office of Education
Master Course Co-Leader, Office of Education
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View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileAdditional Titles
Chair, Breast Cancer Tumor Board, Yale Cancer Center
Curriculum Director, Office of Education
Thread Leader, Pharmacology, Office of Education
Master Course Co-Leader, Office of Education
Contact Info
Are You a Patient?
View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileAdditional Titles
Chair, Breast Cancer Tumor Board, Yale Cancer Center
Curriculum Director, Office of Education
Thread Leader, Pharmacology, Office of Education
Master Course Co-Leader, Office of Education
Contact Info
About
Titles
Professor of Internal Medicine (Medical Oncology)
Chair, Breast Cancer Tumor Board, Yale Cancer Center; Curriculum Director, Office of Education; Thread Leader, Pharmacology, Office of Education; Master Course Co-Leader, Office of Education
Biography
Dr. DiGiovanna is a native of Long Island, NY, who graduated from Cornell University in 1984 with a B.A. and a double major in the fields of biochemistry and music. He attended Yale University from 1984 through 1990 where he was earned the MD and PhD degrees, with his PhD in Pharmacology. He continued his post-graduate training at Yale, performing internship and residency in Internal Medicine, a research post-doctoral fellowship, and a clinical fellowship in Medical Oncology. He is currently an attending physician in Medical Oncology and Professor of Medicine (Oncology) and Pharmacology at Yale University. His clinical specialty is breast cancer and he conducts both clinical and laboratory-based research. His translational laboratory research focuses on signal transduction in breast cancer. He also has had many leadership roles in education at the Yale School of Medicine, including current roles as Co-Director of the Pre-Clerkship Curriculum, Pharmacology Thread Leader, and Co-Leader of the Genes & Development Master Course. Learn more about Dr. DiGiovanna>>
Appointments
Medical Oncology
ProfessorPrimaryPharmacology
ProfessorSecondary
Other Departments & Organizations
- Cancer Signaling Networks
- Center for Breast Cancer
- Internal Medicine
- MD Program
- Medical Oncology
- Molecular Medicine, Pharmacology, and Physiology
- Office of Curriculum
- Pharmacology
- Pusztai Lab
- Subset Medical Oncology Faculty
- WHRY Pilot Project Program Investigators
- Women's Health Research at Yale
- Yale Cancer Center
- Yale Combined Program in the Biological and Biomedical Sciences (BBS)
- Yale Medicine
- Yale Ventures
Education & Training
- Fellow
- Yale School of Medicine (1997)
- Postdoctoral Fellow
- Yale University (1997)
- Resident
- Yale University School of Medicine (1994)
- PhD
- Yale University (1990)
- MD
- Yale University (1990)
- BA
- Cornell University, Biology (Biochemistry), Music (1984)
Research
Overview
We study signal transduction by growth factor receptor tyrosine
kinases, focusing on the EGFR/HER2/ErbB family, including the impact of
signaling by these receptors on clinical outcomes and response to
targeted therapies for cancer, and their potential as therapeutic
targets in novel combination therapies. A major focus in our laboratory
has been the interaction of HER2 signaling with estrogen receptor (ER)
signaling in breast cancer, and with IGF-I receptor
signaling, and the effects of inhibitors of these receptors in
combination targeted therapies. We have also found that in breast
cancer patients, tumors harboring activated HER2 have adverse
prognosis, and these tumors have co-overexpression of EGFR. We continue
to study how signaling by these receptors impacts responses to
different types of therapies and explore targeting these receptors in
combination with other novel targeted therapeutics.
Medical Research Interests
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Lajos Pusztai, MD, DPhil
Donald Lannin, MD
Erin Hofstatter, MD
Andrea Silber, MD
Anees Chagpar, MD, MBA, MPH, FACS, FRCS(C)
Eric Winer, MD
Breast Neoplasms
Protein-Tyrosine Kinases
Signal Transduction
Publications
2024
Trends in breast cancer–specific death by clinical stage at diagnoses between 2000 and 2017
Marczyk M, Kahn A, Silber A, Rosenblit M, Digiovanna M, Lustberg M, Pusztai L. Trends in breast cancer–specific death by clinical stage at diagnoses between 2000 and 2017. Journal Of The National Cancer Institute 2024, djae241. PMID: 39348186, DOI: 10.1093/jnci/djae241.Peer-Reviewed Original ResearchConceptsBreast cancer-specific deathCancer-specific deathBreast cancerStage IAll-cause mortalityTemporal trendsStage I/II breast cancerHormone receptor-positiveNode-negative cancersPrimary tumor typeStage I/II diseaseMetastatic breast cancerStage II cancerBilateral cancerIV cancerFemale sexIV diseaseReceptor-positiveExcellent prognosisII cancerClinical stageTumor typesTreated patientsStage IIICancer
2023
Tucatinib vs Placebo, Both in Combination With Trastuzumab and Capecitabine, for Previously Treated ERBB2 (HER2)-Positive Metastatic Breast Cancer in Patients With Brain Metastases
Lin N, Murthy R, Abramson V, Anders C, Bachelot T, Bedard P, Borges V, Cameron D, Carey L, Chien A, Curigliano G, DiGiovanna M, Gelmon K, Hortobagyi G, Hurvitz S, Krop I, Loi S, Loibl S, Mueller V, Oliveira M, Paplomata E, Pegram M, Slamon D, Zelnak A, Ramos J, Feng W, Winer E. Tucatinib vs Placebo, Both in Combination With Trastuzumab and Capecitabine, for Previously Treated ERBB2 (HER2)-Positive Metastatic Breast Cancer in Patients With Brain Metastases. JAMA Oncology 2023, 9: 197-205. PMID: 36454580, PMCID: PMC9716438, DOI: 10.1001/jamaoncol.2022.5610.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsErbB2-positive metastatic breast cancerMetastatic breast cancerPlacebo-combination groupPositive metastatic breast cancerNew brain lesionsBrain metastasesOverall survivalSubgroup analysisBrain lesionsBreast cancerIntracranial progression-free survivalPlacebo-controlled clinical trialIntracranial objective response rateStable brain metastasesMedian overall survivalObjective response rateProgression-free survivalExploratory subgroup analysisGreater clinical benefitCNS-PFSHER2CLIMB trialIntracranial outcomesFirst progressionMedian ageClinical benefit
2022
Aktualisierte Ergebnisse von Tucatinib versus Placebo in Kombination mit Trastuzumab und Capecitabin bei Patienten mit vorbehandeltem, metastasierten HER2-positiven Brustkrebs mit ZNS-Metastasen (HER2CLIMB)
Greil R, Lin N, Murthy R, Abramson V, Anders C, Bachelot T, Bedard P, Borges V, Cameron D, Carey L, Chien A, Curigliano G, DiGiovanna M, Gelmon K, Hortobagyi G, Hurvitz S, Krop I, Loi S, Loibl S, Mueller V, Oliveira M, Paplomata E, Pegram M, Slamon D, Zelnak A, Ramos J, Feng W, Winer E. Aktualisierte Ergebnisse von Tucatinib versus Placebo in Kombination mit Trastuzumab und Capecitabin bei Patienten mit vorbehandeltem, metastasierten HER2-positiven Brustkrebs mit ZNS-Metastasen (HER2CLIMB). Geburtshilfe Und Frauenheilkunde 2022, 82: e4-e5. DOI: 10.1055/s-0042-1746156.Peer-Reviewed Original Research
2021
How did the COVID crisis affect use of neoadjuvant therapy for patients with breast cancer?
Chagpar A, Lannin D, Mougalian S, Berger E, Gross C, Horowitz N, Sanft T, DiGiovanna M, Golshan M, Pusztai L. How did the COVID crisis affect use of neoadjuvant therapy for patients with breast cancer? Journal Of Clinical Oncology 2021, 39: e18708-e18708. DOI: 10.1200/jco.2021.39.15_suppl.e18708.Peer-Reviewed Original ResearchConceptsUse of NTNeoadjuvant therapyEarly pandemic periodBreast cancerNon-metastatic breast cancerPractice settingsEarly pandemicFlatiron Health databaseNeoadjuvant endocrine therapyTechnology-enabled abstractionSame period one yearSimilar clinicopathologic featuresLongitudinal electronic health recordsPeriod one yearElectronic health recordsTNBC subsetEndocrine therapyPatient ageTN patientsClinicopathologic featuresContemporary cohortClinical stageCancer clinicCancer managementHigh riskAdjuvant T-DM1 versus trastuzumab in patients with residual invasive disease after neoadjuvant therapy for HER2-positive breast cancer: subgroup analyses from KATHERINE
Mamounas EP, Untch M, Mano MS, Huang C, Geyer CE, von Minckwitz G, Wolmark N, Pivot X, Kuemmel S, DiGiovanna MP, Kaufman B, Kunz G, Conlin AK, Alcedo JC, Kuehn T, Wapnir I, Fontana A, Hackmann J, Polikoff J, Saghatchian M, Brufsky A, Yang Y, Zimovjanova M, Boulet T, Liu H, Tesarowski D, Lam LH, Song C, Smitt M, Loibl S. Adjuvant T-DM1 versus trastuzumab in patients with residual invasive disease after neoadjuvant therapy for HER2-positive breast cancer: subgroup analyses from KATHERINE. Annals Of Oncology 2021, 32: 1005-1014. PMID: 33932503, DOI: 10.1016/j.annonc.2021.04.011.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsInvasive disease-free survivalAdjuvant T-DM1Residual invasive diseaseT-DM1 armNeoadjuvant chemotherapyEarly breast cancerHigh-risk tumorsRisk of recurrenceT-DM1Central nervous systemPeripheral neuropathyCNS recurrenceInvasive diseaseBreast cancerHER2-positive eBC patientsInvasive early breast cancerAnthracycline-based neoadjuvant chemotherapyHuman epidermal growth factor receptor 2HER2-positive breast cancerEpidermal growth factor receptor 2Overall riskAdjuvant trastuzumab emtansineBaseline peripheral neuropathyLonger PN durationMore grade 3
2020
Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer
Kunst N, Wang SY, Hood A, Mougalian SS, DiGiovanna MP, Adelson K, Pusztai L. Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer. JAMA Network Open 2020, 3: e2027074. PMID: 33226431, PMCID: PMC7684449, DOI: 10.1001/jamanetworkopen.2020.27074.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsMeSH KeywordsAdo-Trastuzumab EmtansineAdultAgedAnthracyclinesAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAntineoplastic Agents, PhytogenicBreast NeoplasmsCase-Control StudiesCost-Benefit AnalysisCross-Linking ReagentsDrug Therapy, CombinationFemaleHumansImmunosuppressive AgentsMiddle AgedNeoadjuvant TherapyPaclitaxelQuality-Adjusted Life YearsReceptor, ErbB-2TrastuzumabTubulin ModulatorsUnited StatesConceptsErbB2-positive breast cancerAdjuvant treatment strategiesAdjuvant T-DM1Pathologic complete responseT-DM1Treatment strategiesBreast cancerKATHERINE trialResidual diseaseNeoadjuvant regimenHigher health benefitsHealth care payer perspectiveAdjuvant trastuzumab emtansineAnthracycline/cyclophosphamideDifferent adjuvant therapiesFlatiron Health databaseIncremental cost-effectiveness ratioNeoadjuvant treatment optionsHealth benefitsPositive breast cancerCare payer perspectiveCost-effectiveness ratioBase-case analysisDecision analytic modelH. Patients53. TUCATINIB VS PLACEBO ADDED TO TRASTUZUMAB AND CAPECITABINE FOR PATIENTS WITH PREVIOUSLY TREATED HER2+ METASTATIC BREAST CANCER (MBC) WITH BRAIN METASTASES (BM) (HER2CLIMB)
Lin N, Murthy R, Anders C, Borges V, Hurvitz S, Loi S, Abramson V, Bedard P, Oliveira M, Zelnack A, DiGiovanna M, Bachelot T, Chien A, O’Regan R, Wardley A, Mueller V, Carey L, McGoldrick S, An X, Winer E. 53. TUCATINIB VS PLACEBO ADDED TO TRASTUZUMAB AND CAPECITABINE FOR PATIENTS WITH PREVIOUSLY TREATED HER2+ METASTATIC BREAST CANCER (MBC) WITH BRAIN METASTASES (BM) (HER2CLIMB). Neuro-Oncology Advances 2020, 2: ii11-ii11. PMCID: PMC7401403, DOI: 10.1093/noajnl/vdaa073.041.Peer-Reviewed Original ResearchCitationsConceptsMetastatic breast cancerBrain metastasesCNS-PFSSecond progressionControl armEfficacy analysisBrain progressionExploratory efficacy analysesMedian CNS-PFSBaseline brain MRIMedian OSOverall deathRECIST 1.1Study therapyMedian timeInvestigator's evaluationIC diseaseLocal treatmentBreast cancerBrain MRIReduced riskCapecitabineTrastuzumabTucatinibHER2Tucatinib versus placebo added to trastuzumab and capecitabine for patients with previously treated HER2+ metastatic breast cancer with brain metastases (HER2CLIMB).
Lin N, Murthy R, Anders C, Borges V, Hurvitz S, Loi S, Abramson V, Bedard P, Oliveira M, Zelnak A, DiGiovanna M, Bachelot T, Chien A, O'Regan R, Wardley A, Müller V, Carey L, McGoldrick S, An G, Winer E. Tucatinib versus placebo added to trastuzumab and capecitabine for patients with previously treated HER2+ metastatic breast cancer with brain metastases (HER2CLIMB). Journal Of Clinical Oncology 2020, 38: 1005-1005. DOI: 10.1200/jco.2020.38.15_suppl.1005.Peer-Reviewed Original ResearchCitationsAltmetricConceptsMetastatic breast cancerProgression-free survivalObjective response rateBrain metastasesOverall survivalCNS-PFSControl armSecond progressionEfficacy analysisBrain progressionLocal treatmentBreast cancerProlongation of PFSMedian progression-free survivalExploratory efficacy analysesMedian CNS-PFSMedian overall survivalBaseline brain MRIHER2 kinase inhibitorDeath overallRECIST 1.1Study therapyFree survivalInvestigator's evaluationIC disease
2018
Durvalumab (MEDI4736) concurrent with nab-paclitaxel and dose dense doxorubicin cyclophosphamide (ddAC) as neoadjuvant therapy for triple negative breast cancer (TNBC).
Pusztai L, Hofstatter E, Chung G, Horowitz N, Lannin D, Killelea B, Chagpar A, DiGiovanna M, Frederick C, Burello T, Harigopal M. Durvalumab (MEDI4736) concurrent with nab-paclitaxel and dose dense doxorubicin cyclophosphamide (ddAC) as neoadjuvant therapy for triple negative breast cancer (TNBC). Journal Of Clinical Oncology 2018, 36: 586-586. DOI: 10.1200/jco.2018.36.15_suppl.586.Peer-Reviewed Original ResearchCitations
2017
Pathologic complete response (pCR) rates after neoadjuvant pertuzumab (P) and trastuzumab (H) administered concomitantly with weekly paclitaxel (T) and 5-fluorouracil/epirubicin/cyclophosphamide (FEC) chemotherapy for clinical stage I-III HER2-positive breast cancer.
Foldi J, Mougalian S, Silber A, Lannin D, Killelea B, Chagpar A, Horowitz N, Frederick C, Rispoli L, Abu-Khalaf M, Sabbath K, Sanft T, Fischbach N, Brandt D, Hofstatter E, DiGiovanna M, Pusztai L. Pathologic complete response (pCR) rates after neoadjuvant pertuzumab (P) and trastuzumab (H) administered concomitantly with weekly paclitaxel (T) and 5-fluorouracil/epirubicin/cyclophosphamide (FEC) chemotherapy for clinical stage I-III HER2-positive breast cancer. Journal Of Clinical Oncology 2017, 35: 577-577. DOI: 10.1200/jco.2017.35.15_suppl.577.Peer-Reviewed Original ResearchCitationsAltmetricConceptsPathologic complete response rateHER2-positive breast cancerDual HER2 blockadeComplete response ratePCR rateEstrogen receptorHER2 blockadeBreast cancerStage IResponse rateGrade 3/4 adverse eventsSymptomatic congestive heart failureClinical stage ICompletion of chemotherapyPhase II studyTaxane-based chemotherapyCongestive heart failureEfficacy of anthracyclinesPositive breast cancerNormal cardiac functionEntire treatment durationER cohortER- cancersNeoadjuvant pertuzumabWeekly paclitaxel
Clinical Trials
Current Trials
2000033529: A pilot study to evaluate biomarkers and safety of dapagliflozin concomitant with neoadjuvant therapy for patient with HER2-negative early-stage breast cancer and hyperinsulinemia (previously HIC 2000031461) [Yale HIC]
HIC ID2000033529RoleSub InvestigatorPrimary Completion Date12/31/2025Recruiting ParticipantsAn Open-Label Phase II Trial to Evaluate the Efficacy and Safety of Neoadjuvant Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel Plus Trastuzumab and Pertuzumab in Early Stage HER2-Negative Breast Cancer Patients Selected With a Test Measuring Live Cell HER2 Signaling Transduction (FACT 1)
HIC ID2000025449RolePrincipal InvestigatorPrimary Completion Date10/30/2023Recruiting ParticipantsThe CompassHER2 Trials (Comprehensive Use of Pathologic Response Assessment to Optimize Therapy in HER2-Positive Breast Cancer) CompassHER2 Residual Disease (RD), a Double-Blinded, Phase III Randomized Trial of T-DM1 Compared With T-DM1 and Tucatinib
HIC ID2000030282RoleSub InvestigatorPrimary Completion Date01/01/2028Recruiting ParticipantsA Randomized Phase II Trial Of Circulating Tumor DNA-Guided Second Line Adjuvant Therapy For High Residual Risk, Stage II-III, Hormone Receptor Positive, HER2 Negative Breast Cancer
HIC ID2000029678RoleSub InvestigatorPrimary Completion Date12/15/2023Recruiting ParticipantsRandomized Non-Inferiority Trial Comparing Overall Survival of Patients Monitored With Serum Tumor Marker Directed Disease Monitoring (STMDDM) Versus Usual Care in Patients With Metastatic Hormone Receptor Positive Breast Cancer
HIC ID2000024170RoleSub InvestigatorPrimary Completion Date01/01/2035Recruiting Participants
Academic Achievements & Community Involvement
activity JCO Precision Oncology
Journal ServiceReviewerDetails02/01/2018 - Presentactivity Clinical Cancer Research
Journal ServiceReviewerDetails07/01/2003 - Presentactivity Breast Cancer Research and Treatment
Journal ServiceReviewerDetails07/01/2010 - Presentactivity British Journal of Cancer
Journal ServiceReviewerDetails07/01/2003 - Presentactivity Cancer Research
Journal ServiceReviewerDetails07/01/2006 - Present
Clinical Care
Overview
Michael DiGiovanna, MD, PhD, is a professor of internal medicine at Yale School of Medicine and, as a Yale Medicine oncologist, treats cancer patients at the Yale Cancer Center. His primary focus is the treatment and management of breast cancer.
Dr. DiGiovanna has conducted both clinical and laboratory-based research having led a translational laboratory focused on signal transduction in breast cancer. His research delves into breast cancer treatment strategies, including studies of targeted drug combinations for treating breast cancer. Dr. DiGiovanna’s work has been recognized with several awards and grants, including an American Cancer Society Research Scholar Grant and a Women's Health Investigator Award.
Clinical Specialties
Fact Sheets
Hormonal Therapy for Cancer
Learn More on Yale MedicineBreast Cancer
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News
- January 29, 2024
Comprehensive Breast Cancer Care at Smilow Cancer Hospital in New Haven
- June 19, 2023
Profiles in Survivorship: Sheri Steinmetz
- October 06, 2021Source: WTNH.com
Two-time Breast Cancer Survivor Refuses to Let Cancer Stop Her from Leading by Positive Example
- June 14, 2021
Meet Dr. Michael DiGiovanna
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Are You a Patient? View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.