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Machiels M, Oulkadi R, Tramm T, Stecklein SR, Somaiah N, De Caluwé A, Klein J, Tran WT, Salgado R. Individualising radiation therapy decisions in breast cancer patients based on tumour infiltrating lymphocytes and genomic biomarkers. Breast 2023; 71:13-21. [PMID: 37437386 PMCID: PMC10512095 DOI: 10.1016/j.breast.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
Radiation therapy (RT) has long been fundamental for the curative treatment of breast cancer. While substantial progress has been made in the anatomical and technological precision of RT delivery, and some approaches to de-escalate or omit RT based on clinicopathologic features have been successful, there remain substantial opportunities to refine individualised RT based on tumour biology. A major area of clinical and research interest is to ascertain the individualised risk of loco-regional recurrence to direct treatment decisions regarding escalation and de-escalation of RT. Patient-tailored treatment with RT is considerably lagging behind compared with the massive progress made in the field of personalised medicine that currently mainly applies to decisions on the use of systemic therapy or targeted agents. Herein we review select literature surrounding the use of tumour genomic biomarkers and biomarkers of the immune system, including tumour infiltrating lymphocytes (TILs), within the management of breast cancer, specifically as they relate to progress in moving toward analytically validated and clinically tested biomarkers utilized in RT.
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Affiliation(s)
- Melanie Machiels
- Department of Radiation Oncology, Iridium Netwerk, University of Antwerp, Health & Sciences, Antwerp, Belgium.
| | - Redouane Oulkadi
- Department of Radiation Oncology, Iridium Netwerk, University of Antwerp, Health & Sciences, Antwerp, Belgium
| | - Trine Tramm
- Department of Pathology, Aarhus University Hospital, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Shane R Stecklein
- Departments of Radiation Oncology, Pathology & Laboratory Medicine, And Cancer Biology, The University of Kansas Medical Center, KS, USA
| | - Navita Somaiah
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, Breast Unit, The Royal Marsden NHS Foundation Trust, UK
| | - Alex De Caluwé
- Université Libre de Bruxelles (ULB), Hôpitaux Universitaires de Bruxelles (H.U.B), Institut Jules Bordet, Brussels, Belgium
| | - Jonathan Klein
- State University of New York (SUNY) Downstate Health Sciences University and Maimonides Medical Center, NY, United States
| | - William T Tran
- Department of Radiation Oncology, University of Toronto & Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Roberto Salgado
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Pathology, GZA - ZNA Hospitals, Antwerp, Belgium
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