Preventing unnecessary breast cancer treatment

 A team of 13 investigators

The Netherlands, UK and USA

  Pathologists, oncologists, biologists, geneticists

  £15M

  5 years

 Distinguish between lethal cancers that need treating, and non-lethal cancers that don’t

Millions of women attend breast screening every year, but often lesions show up that will never go on to turn into full-blown breast cancer. Because doctors don’t know which of these lesions could be dangerous, they often treat women just in case. In our project we will study thousands of these lesions in great detail to understand which are low- and high- risk and help doctors to make more informed decisions about treatment.

Professor Jelle Wesseling, Principal Investigator 

Their project

Background

Ductal carcinoma in situ (DCIS) is a condition that can sometimes develop into breast cancer. Each year it affects more than 6,300 women in the UK, and thousands more worldwide.

But right now, doctors can’t tell whether women with DCIS will go on to develop breast cancer. This means that, unfortunately, some women with DCIS undergo hospital visits, surgery and even chemotherapy and radiotherapy that they don’t need, while also causing them unnecessary stress and anxiety.

Professor Jelle Wesseling and his team of scientists from the UK, Netherlands and the US want to change this, and stop women getting treatment they won’t benefit from.

The Research

To achieve their aim, Wesseling’s team will study tissue samples taken from women with DCIS during surgery. These samples will come from women living in the UK, US and the Netherlands.

They will look at these samples in great detail, studying their characteristics, including their genetic make-up and what kind of immune cells they contain. Alongside this, they will gather clinical information about these women, recording whether their DCIS came back, if they later developed breast cancer, and if so, whether it spread.

The team will then combine all of this information and use mathematical modelling to search for clues (biomarkers) in the DNA of women who have had DCIS, that could indicate how likely they are to develop breast cancer later on.

Once they have identified potential biomarkers, they will test them in larger clinical trials for women with DCIS. Their goal is to find out whether these biomarkers can accurately and reliably distinguish between women with DCIS who will likely develop breast cancer and should be treated, and those who can safely avoid treatment.

The Impact

By identifying biomarkers that can distinguish DCIS patients with a low risk of developing cancer from patients with a high risk, this project has the potential to reduce over-treatment of DCIS patients.

Ultimately, Wesseling’s team hopes to spare thousands of women unnecessary treatment while making sure those who need it, get it.

Project update - Year one

This team has made considerable progress in their first year. Crucially, they have put in place the necessary agreements and contracts to transfer valuable tissues and data across geographical borders, enabling them to establish a truly global collaboration.

They then focused their attention on the comprehensive characterisation of thousands of DCIS samples and the complementary clinical information, while also establishing a number of novel lab-based models of DCIS that will allow them to validate and interrogate their findings from the clinical samples.

Looking ahead, the team is carefully planning and agreeing how they will collect and analyse samples and data from women with DCIS taking part in three ongoing clinical trials in the US, the UK and the Netherlands. Coordinating processes across the three trials is critical, so they can robustly verify whether their risk-prediction model is accurate and consistent. This will ensure that doctors can reliably use the outcomes of this Grand Challenge in the future to help women with DCIS make the right choices about their treatment. 

Working in partnership

Dutch Cancer Society

We’re partnering with the Dutch Cancer Society to fund the PRECISION Grand Challenge team. This international partnership between two of the world’s leading cancer charities allowed us to pool our resources to fund ambitious, large-scale research that may not have been possible otherwise.

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