PRE-ACT

The PRE-ACT consortium is going to predict the risk of radiotherapy side effects, including arm lymphedema in breast cancer patients by using explainable Artificial Intelligence (AI).

Radiotherapy is a widely used cancer treatment, however some patients suffer side effects. In breast cancer, side effects can include breast atrophy, arm lymphedema, and heart damage. Some factors that increase risk for side effects are known, but current approaches do not use all available complex imaging and genomics data. The time is now ripe to leverage the huge potential of AI towards prediction of side effects. This project will use rich datasets from three patient cohorts to design and implement an AI tool that predicts the risk of side effects, including arm lymphedema in breast cancer patients and provides an easily understood explanation to support shared decision-making between the patient and physician.

Explainable AI with improved predictive power for radiotherapy toxicity will enable clinical trials in which the AI is used to stratify patients for treatment modification. It will also lead to a widespread radical change of clinical practice on how crucial decisions are taken, especially in the first stages of cancer treatment. Future examples will include: (i) giving suitable patients hypofractionated radiotherapy with a reduced number of larger doses, which could lead to reduced side-effects and is less time-consuming for patients; (ii) treating early stage breast tumours with partial breast irradiation in patients at high risk for side effects; (iii) advising selected patients whether to have a mastectomy (thus avoiding radiotherapy) or a reduction mammoplasty prior to radiotherapy; (iv) deciding whether to use conventional photon radiotherapy or more expensive proton therapy.

This project was awarded funding by Horizon Europe in 2022.