Mark Sandman, 47, collapsed on stage at the end of his second song in front of nearly 2,000 spectators in Palestrina, outside Rome, said police.

A doctor rushed to the scene and performed a cardiac massage, but the singer died as an ambulance drove him to hospital.

The Boston trio are eschewing the guitar sound of so many bands and instead adding saxophone sounds to rock music.

Sandman sang and played bass, together with Dana Colley on saxophone and Billy Conway on drums.

British singer PJ Harvey once described them as "one of the most sexy bands because it's just slide bass guitar, low baritone saxophone and drums."

Mark Sandman said they were trying to achieve a basic sound. "It's all about simplicity, and playing with dynamics," he has said.

"It's about subtraction more than production."

The trio emerged playing bars around Boston in the early 1990s. They went on to build a cult following across the world.