PRECISION

Challenge

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

Researchers
13
Principal Investigator
Professor Jelle Wesseling
Location
The Netherlands, UK and USA
Funded By
Cancer Research UK and the Dutch Cancer Society - £15m
Specialisms
Pathology, oncology, biology, genetics

Preventing unnecessary treatment

By distinguishing between people with DCIS who will develop breast cancer and those who won’t, the PRECISION team could spare thousands of women around the world unnecessary treatment, transforming their quality of life.   

First, do no harm

Funded by:

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KWF

‘First, do no harm’: the fundamental message of the Hippocratic Oath, pledged by all newly trained doctors around the world.   

But when treating women with ductal carcinoma in situ (DCIS), a condition that can sometimes develop into breast cancer, doctors can inadvertently do a lot of harm. Despite most DCIS diagnoses remaining indolent, there is currently no way to distinguish between people whose DCIS will or won’t develop into breast cancer.   

Unfortunately, this means that thousands of women with DCIS undergo hospital visits, surgery and even hormonal therapy and radiotherapy they don’t need, while also experiencing the associated unnecessary stress and anxiety.   

Looking to change this is the PRECISION team: a group of experts from the Netherlands, UK and US. They’re on the hunt for biological clues – known as biomarkers – that could indicate whether a person with DCIS is likely to develop breast cancer. Ultimately, they want to help doctors give women a definitive answer to important questions: what is their individual risk of developing cancer? And do they need to undergo treatment? 

Professor Jelle Wesseling, Principal Investigator, PRECISION

Senior Group Leader, The Netherlands Cancer Institute; Professor of Breast Pathology, Leiden University Medical Center

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.

On the hunt for clues

Playing a starring role in PRECISION’s approach is a cohort of high-quality patient samples, collected from women in the Netherlands, UK and US undergoing surgery for their DCIS.   

The team will scrutinise the characteristics of these samples, including their genetic makeup and the kind of immune cells they contain. Long-term clinical information about these women will also be gathered, recording whether their DCIS came back, if they later developed breast cancer and, if so, whether it spread. Using mathematical modelling, the team will search for any patterns in the samples that correlate with patient outcome.   

Professor Jelle Wesseling

A definitive answer

Once the team has identified potential biomarkers, they’ll test them in larger clinical trials for women with DCIS, to see whether they can accurately predict whether a person will develop breast cancer. Their ultimate goal is to develop a test that accurately and reliably tells women with DCIS whether they need to receive treatment or not.   

PRECISION’s ambition has the potential to dramatically improve quality of life for people living with DCIS, sparing thousands of people unnecessary treatment while making sure those who need it, get it.   

The power of collaboration

Having access to high-quality patient samples with this much clinical information will enable the team to study DCIS in a way that hasn’t been doable before. This was made possible by a collaboration sparked at a scientific conference and nurtured ever since.  

Professor Jelle Wesseling, Principal Investigator, PRECISION
Professor Alastair M Thompson
Dr Serena Nik-Zainal
Professor Jos Jonkers
Dr Esther Lips
Dr Andrew Futreal
Professor Daniel Rea
Professor Elinor Sawyer
​​​​​​Associate Professor Nicholas Navin
Professor Fariba Behbod
Professor Jacco van Rheenen
Donna Pinto
Hilary Stobart
Ellen Verschuur
Marja van Oirsouw