Livia Onofrio

Specialist Register GMC Reference n. 8097637(starting from 11/03/2025)

OM RM M 63843 (starting from 15/03/2018)

I participated in both diagnostic and research activities, under the supervision of Prof. Umberto Malapelle. I shadowed scientists and I gained experience in liquid biopsy, NGS (Ion Torrent®), qPCR (LightCycle TaqMan™ Gene Expression Assays,
cfDNA manual extraction; sequencing DNA/RNA quantification using Qubit Fluorometer; nanocapillary multifluidic platform 4200 TapeStation (Agilent Technologies) for evaluating quality and quantity of cfDNA from liquid biopsy and tissue samples
(e.g. microsatellites instability profile, MSI); mutation testing in solid tumors with NGS, dPCR,and RT-PCR; immune-profile and tumor-characterization with IHC;
Expanded gene panels integration into clinical practice;
NGS platforms & library preparation (Genexus, Illumina, Thermo Fisher, SOPHiA DDM); HRD, BRCA & methylation profiling (Oncomine, Hedera, Amoy Dx);
Tumor mutational burden (TMB) analysis (Oncomine TML assay); MSI-H/dMMR assessment (Idylla™, TapeStation 4200, IHC);
Use of SiRe panel (568 mutations in EGFR, KRAS, NRAS, BRAF, cKIT, PDGFRα);
Use of Nexthyro panel (15 genes for thyroid tumorigenesis, 100% specificity, 2% sensitivity).

I am responsible for devices and drugs check-list and medical prescriptions.

I supervise the private ambulance service and the staff, providing continuous professional development opportunities and recognized training (e.g. BLSD courses) to maintain and strengthen competencies.

I served as Ambulance's Medical Doctor during during sports competitions (Series A and B water polo matches, swimming-pool, synchronized swimming, lifesaving swimming events, marathons, bikes competitions and football matches, and horse-riding).

• I designed and performed a liquid biopsy experiment from healthy donors with the NAB Group on Clinical and Experimental Pharmacology (CEP). The project aimed to determine how pre-analytical variables, such as several freeze-thaw cycles, may affect the integrity of ccfDNA, as well as how long the plasma could be stored at -20°C before the loss of cfDNA integrity is observed. I acquired expertise in cfDNA isolation from human plasma, both manually (magnetic beads) and using an automated system (EZ2). I have gained autonomy in assessing the quality of cfDNA fragments obtained using the TapeStation, which analyzes the fragments lengths with TapeScreen assays. The preliminary data were presented with a poster (ref. to"Conference Abstracts").
• I also worked on a T-cell citotoxicity project with the Upper- Gastro-Intestinal and NET Team of The Christie, isolating PBMCs from whole blood of human healthy volunteers. I gained autonomy in plasma separation, PBMCs isolation, culturing, cell counting, and cfDNA sequencing through qPCR.

• I served as palliative care physician at the Hospice in Rocca di Papa (Rome). Additionally, I worked as on-call doctor across the rehabilitation and long-term departments in both Rocca di Papa and Montecompatri sites.
• Diagnosed and treated patients suffering from chronic conditions.
• Established strong relationships with patients and their families, fostering trust and commitment to the end-of-life healthcare plan.
• Educated patients and families on benefits of healthy diet and adequate exercise.

As a medical oncology resident, within 5-year residency I had the opportunity to gain experience in both laboratory and clinical settings:
1st year. Dept. of Onco-Haematology, Diagnostic Imaging and Morphology, and Legal Medicine at the Policlinic Federico II of Naples

I was involved in laboratory activities at the Department of Clinical Medicine and Surgery, University of Naples Federico II , under the supervision of Prof Roberto Bianco, who was working on experiments evaluating resistance to endocrine therapy and CDK4/6 inhibitors in ER+ breast cancer and also on synergistic inhibition of human pancreatic cancer cell growth combining cytotoxic drugs with anti-sense oligonucleotides targeting protein-kinases.

I served as resident at the Centre of expertise for rare tumors. I also worked for two months in the department of medical oncology at Cardarelli Hospital , where I participated in multidisciplinary team meetings and gained experience in publishing peer-reviewed papers.

2nd year. University of Rome La Sapienza. Dept. of Radiological, Oncological and Pathological Sciences, Policlinic Umberto I. served as general medical oncology trainee at the day hospital and clinics. I actively participated to multidisciplinary meetings for each group disease. I also completed a lab internship at the Department of Molecular Medicine , faculty of Medicine and Pharmacology, under the supervision of Prof Giuseppe Giannini. He was working on targets and mechanisms of MYCN-driven neuronal tumor development and STING reactivation in MYCN-driven in vitro models.

3rd year) University of Milan Statale. I broadened my experience in clinical research at the IRCSS European Institute of Oncology (IEO) in Milan, gaining extensive experience in phase I clinical trials under the guidance of Prof. Giuseppe Curigliano, as well as in phase II and III trials in the Melanoma and Sarcomas Department under the supervision of Prof. Paola Queirolo. This
invaluable experience provided me with significant expertise in managing and reporting experimental drugs-related toxicity and irAEs, monitoring patients enrolled in clinical trials. I participated to multidisciplinary teams meetings as well as to molecular tumor board meetings. I gave familiarity with decision-making aspects of personalized therapy, based on tumor-agnostic decision and the mutational profil identified in individual patients.

I also completed training in the Department of Medical Oncology, focusing on Urogenital and Head and Neck tumor treatments at the same institute.

I actively participated, also as speaker, in national meetings about management of immunotherapy in solid tumors, enabling me to build strong professional networks with other italian institutions.

Working within the Melanoma Team, I published as first author a meta-analysis and systematic review comparing the target therapy with the immunotherapy as the best treatment option for BRAF V600E melanoma metastatic to the brain. The abstract was presented in 2023 at the annual conference of Italian Association of Medical Oncology (AIOM).

4th & 5th year. University of Rome Tor Vergata, Policlinic Tor Vergata , Department of onco-haematology, Complex Operative Unit of Medical Oncology. I served as senior resident within the outpatient clinic, day hospital, and inpatient ward. I completed further training in: emergency medicine, clinical oncology, and palliative care at the ESMO designated Centre San Raffaele S.p.A (in Cassino and Rome).

• Supervised the private ambulance staff, providing continuous training to maintain the competencies in emergency medicine.
• I oversaw the patients transfers as well as the ambulance activities in social and sporting public events;
• My responsibilities encompassed monitoring the inventory and functionality of medical devices and medications and authorizing drugs prescriptions, according to the guidelines, the regulatory agency and the updated regulations;
• I was responsible for the drugs check-list monitoring

I served as a ward physician. within the Department of Internal Medicine, carrying out patient examinations, updating medical records, and managing emergency situations. Moreover, I established strong relationships with nurse staff, patients and their families, fostering trust and commitment to the healthcare plan.

I served as vaccinating doctor for the COVID-19 pandemic within the vaccination centers of

Pantigliate - CV Esselunga Pantigliate and Vizzolo Predabissi, in Milan
(ASST Melegnano e della Martesana
Via Pandina, 1 – 20070 Vizzolo Predabissi)

• I developed strong rapport with colleagues and staff members, promoting teamwork within the workplace environment.
• I assessed the patient's eligibility and I provided information about: vaccines purposes, benefits, and potential side effects;
• I administered vaccines for Sars-CoV-2, maintaing sterility and safety;
• I registered and recorded patients data on electronic system for the National Health Service database

I served as Medical Doctor within the Emergency Department and Public Ambulance Service within the hospitals of ULSS 6 Euganea:

Cittadella Hospital: 28, Via dei Pilastroni - 35013 Cittadella, Padua

Montagnana Hospital: 16, Via Ospedale - 35044

Montagnana, Pauda

I was in charge of the medical assistance in both emergency room and during ambulance transfers.

I served as on-call doctor

• I served as Medical Doctor in emergency room at the Cirié Hospital in 7, Via Battitore - 10073 Cirié, Turin
• I supervised other professional or non-professional personnel and provided medical instructions.
• I demonstrated proper techniques for first aid.
• Provided emergency treatment onsite and responded in urgent situations.
• Supported standards of medical care by adhering to policies and procedures.

I served as on-call doctor in both sites:

30, Via Maresciallo Caviglia - 00195 Rome;

625, Via di Boccea - 00166 Rome

I shadowed scientist within the Immunotherapy Unit, Department of Research, Advanced Diagnostic and Technological Innovation of the Translational Research Functional Departmental Area in I.F.O. Hospital, Regina Elena National Cancer Institute in Rome.
Under the supervisor of Prof. Paola Nisticò, I gained proficiency in:
Setting up cancer cell cultures;

study of TILs (Tumor Infiltrating Lymphocytes) with electron microscope; study of cells with con focal microscope; FACs analysis of circulating lymphocytes; Western Blot and ELISA techniques;
Lymphocytes HLA-2 typing;

setting up CD8+T cells cultures with PHA.

I served as emergency doctor in emergency room at the Lanzo Hospital in 30, Via Dei Marchesi della Rocca - 10074 Lanzo Torinese, Turin.

• Performed physical exams on patients, continuously communicating about patient needs and comfort levels.
• Stayed current on medical advancements through continuous professional development opportunities such as workshops, conferences, and online courses.
• Managed chronic conditions effectively by creating tailored long-term care plans for individual patients.
• Improved patient satisfaction by providing comprehensive and empathetic care during consultations.

I served as locum agency Medical Doctor at the private hospital in 6, Via dei Pioppi - 00172 Rome.

Clinical Biochemical Analysis Laboratory Unit - Department of Diagnostic Sciences.
Under the supervision of Prof. Maurizio Simmaco, I gained proficiency in:
Indirect Immunofluorescence in tissues for detection of human auto- antibodies (ANA, EMA, ICAs, SMAs, AMAs, anti-LMK, APCAs);

Immunoblot procedures for detecting extensive antibody profiles ENA.

Clinical Biochemical Analysis Laboratory Unit - Department of Diagnostic Sciences.
Under the supervision of Prof. Maurizio Simmaco, I gained proficiency in:
Indirect Immunofluorescence in tissues for detection of human auto- antibodies (ANA, EMA, ICAs, SMAs, AMAs, anti-LMK, APCAs);

Immunoblot procedures for detecting extensive antibody profiles ENA.