The aim of the “European network staff eXchange for integrAting precision health in the health Care sysTems (ExACT)” is to train a new generation of professionals that can contribute to the future of health and healthcare (HC), by providing high-quality, multidisciplinary knowledge in precision health. The greater personalisation of HC is a driver of innovation for research, and for the healthcare system and industry. Still policy makers, HC professionals, citizens, and private companies need to take some steps to realize its potential. In order to harness this challenging landscape, the ExACT consortium provides a cohesive framework for training staff across 7 EU Countries, 1 AC and 2 TCs. During 4 years, the staff involved will be trained on research topics not available at the home institutions thanks to 74 secondments. They will attend courses, workshops, seminars, conferences, and will participate in organizing outreach activities, thus acquiring new skills. Research topics include: Integration of Big Data and digital solutions into the HC systems; Designing and promoting innovative citizen engagement models; Education of healthcare professionals and leadership; Health Technology Assessment in precision health; Ethical-legal, social, organisational and policy issues surrounding precision health. ExACT is embedded in existing cooperation structures, such as the RISE-PRECeDI project, IC PerMed, and CSA TO-REACH. The consortium consists of 15 beneficiaries and 2 partners, of which 10 are academic institutions including Stanford University where a precision health program has been launched, and 7 non academics including 2 SMEs. The participants will produce key reports, policy recommendations, scientific publications, and information materials for citizens, thus fostering public-private interactions. In the long run, ExACT will foster the integration of precision health in the EU HC systems, thus contributing to better health for Europeans citizens.

Breast tumours are heterogeneous, and result from the complex interplay of multiple lifestyle/environmental and genetic risk factors. Through the EU-funded COGS project, we have identified a large number of germline variants that influence the risk of breast cancer. In combination, these variants can identify women at wide ranges of genetic risk, even in the absence of family history of breast cancer. Given that breast cancer is not one disease, it is now essential to better understand how risk factors act together to influence the development of pathologic-molecular subtypes of breast cancer. The aim of B-CAST is to identify women at moderate to high risk of breast cancer, the subtype of cancer that is most likely to develop and the prognosis of that particular subtype. This will be accomplished through large-scale pathologic-molecular analyses of over 20,000 breast tumours, and the integration of these data with unique resources from existing consortia, including germline, lifestyle/environmental, mammographic breast density, pathologic and clinical data. This information will inform the development of risk prediction and prognostication models that will be validated in longitudinal cohorts and clinical studies, and incorporated into online tools. We will also disseminate this knowledge to relevant stakeholders, and evaluate how to translate it into risk-stratified public health and clinical strategies. The current challenge for optimised prevention, early detection, and treatment decisions for breast cancer is understanding the genetic and lifestyle determinants of risk and prognosis of molecular subtypes. B-CAST will add to this understanding and will have immediate application with benefits to women by providing validated risk and prognostication tools. This will empower women and doctors with knowledge to tailor strategies for prevention and treatment. Ultimately, this work should result in reductions in the occurrence, morbidity and mortality of this disease.