Wolfson Institute of Preventive Medicine - Barts and The London

Biomarkers for breast DCIS progression

Centre for Cancer Prevention

Project Investigator:  Professor Jack Cuzick

Overview

The appropriate management of DCIS (ductal carcinoma in situ) is one of the biggest challenges in breast cancer management today.

We are undertaking biomarker studies in the UK/ANZ 2x2 trial of tamoxifen and radiotherapy in 1,701 women with locally excised DCIS.  Biomarker work is well underway looking at IHC markers (ER, PgR, HER2, Ki67 and others) and expression profiles, but no results are available at this time.

Diagnostic blocks from more than 900 women have been collected.

Long term follow up is continuing and the 12.7 year median follow-up was recently presented which showed a continuing benefit for radiotherapy on local recurrence and a benefit of tamoxifen only for new contralateral tumours. No effect on distant recurrence of breast cancer or other deaths have been seen.

A new classification system for DCIS has been derived for the material in this trial.

Publications

Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial. Lancet Onc. 2011 Jan;12(01):21-9.
Cuzick, J, Sestak I, Pinder SE, Ellis IO, Forsyth S, Bundred NJ, Forbes JF, Bishop H, Fentiman IS, George WD.

A new pathological system for grading DCIS with improved prediction of local recurrence: results from the UKCCCR/ANZ DCIS trial. Br J Cancer. 2010 Jun 29;103(1):94-100.
Pinder SE, Duggan C, Ellis IO, Cuzick J, Forbes JF, Bishop H, Fentiman IS, George WD; UK Coordinating Committee on Cancer Research (UKCCCR) Ductal Carcinoma In Situ (DCIS) Working Party.

Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia and New Zealand: randomised controlled trial. Lancet. 2003 Jul 12;362 (9378):95-102.
Houghton J, George WD, Cuzick J, Duggan C, Fentiman IS, Spittle M; UK Coordinating Committee on Cancer Research; Ductal Carcinoma in situ Working Party; DCIS trialists in the UK, Australia and New Zealand.