Max S Mano1, Leandro Jonata C Oliveira2, Samir A Hanna3. 1. Centro Paulista de Oncologia (CPO) - Unidade Faria Lima Endereço, Av. Brigadeiro Faria Lima, 4300 Grupo Oncoclínicas (GOC), São Paulo, SP, 04538-132, Brazil. max.mano@medicos.oncoclinicas.com. 2. Centro Paulista de Oncologia (CPO) - Unidade Faria Lima Endereço, Av. Brigadeiro Faria Lima, 4300 Grupo Oncoclínicas (GOC), São Paulo, SP, 04538-132, Brazil. 3. Department of Radiation Oncology - Hospital Sírio-Libanês, Rua Dona Adma Jafet, 91, Oncology Center, São Paulo, 01308-050, Brazil.
Abstract
PURPOSE OF REVIEW: Because of the strong prognostic value of pathologic complete response (pCR) in early breast cancer (EBC), patients who fail to achieve this outcome have increasingly been eligible to a new treatment modality, namely post-neoadjuvant systemic therapy (PNT). However, adjuvant radiation therapy (RT) retains a crucial role in EBC, and also needs to be timely administered to patients. To address how modern PNT optimally integrates with adjuvant RT is therefore the purpose of this review. RECENT FINDINGS: How PNT administration optimally integrates with adjuvant RT has varied depending on the type of systemic therapy employed. The introduction of novel "targeted" agents has created new challenges, as for many of them limited information is available on the feasibility of concurrent systemic and RT administration or their optimal sequencing. PNT and RT are both of utmost importance to the management of EBC and need to be timely and safely administered to patients. The optimal strategy to integrate these modalities may vary according to the type of PNT agent and other factors.
PURPOSE OF REVIEW: Because of the strong prognostic value of pathologic complete response (pCR) in early breast cancer (EBC), patients who fail to achieve this outcome have increasingly been eligible to a new treatment modality, namely post-neoadjuvant systemic therapy (PNT). However, adjuvant radiation therapy (RT) retains a crucial role in EBC, and also needs to be timely administered to patients. To address how modern PNT optimally integrates with adjuvant RT is therefore the purpose of this review. RECENT FINDINGS: How PNT administration optimally integrates with adjuvant RT has varied depending on the type of systemic therapy employed. The introduction of novel "targeted" agents has created new challenges, as for many of them limited information is available on the feasibility of concurrent systemic and RT administration or their optimal sequencing. PNT and RT are both of utmost importance to the management of EBC and need to be timely and safely administered to patients. The optimal strategy to integrate these modalities may vary according to the type of PNT agent and other factors.
Entities:
Keywords:
Early breast cancer; Post-neoadjuvant therapies; Radiotherapy
Authors: Ian H Kunkler; Linda J Williams; Wilma J L Jack; David A Cameron; J Michael Dixon Journal: Lancet Oncol Date: 2015-01-28 Impact factor: 41.316
Authors: Edith A Perez; Edward H Romond; Vera J Suman; Jong-Hyeon Jeong; George Sledge; Charles E Geyer; Silvana Martino; Priya Rastogi; Julie Gralow; Sandra M Swain; Eric P Winer; Gerardo Colon-Otero; Nancy E Davidson; Eleftherios Mamounas; Jo Anne Zujewski; Norman Wolmark Journal: J Clin Oncol Date: 2014-10-20 Impact factor: 44.544
Authors: C M Perou; T Sørlie; M B Eisen; M van de Rijn; S S Jeffrey; C A Rees; J R Pollack; D T Ross; H Johnsen; L A Akslen; O Fluge; A Pergamenschikov; C Williams; S X Zhu; P E Lønning; A L Børresen-Dale; P O Brown; D Botstein Journal: Nature Date: 2000-08-17 Impact factor: 49.962
Authors: Dennis Slamon; Wolfgang Eiermann; Nicholas Robert; Tadeusz Pienkowski; Miguel Martin; Michael Press; John Mackey; John Glaspy; Arlene Chan; Marek Pawlicki; Tamas Pinter; Vicente Valero; Mei-Ching Liu; Guido Sauter; Gunter von Minckwitz; Frances Visco; Valerie Bee; Marc Buyse; Belguendouz Bendahmane; Isabelle Tabah-Fisch; Mary-Ann Lindsay; Alessandro Riva; John Crown Journal: N Engl J Med Date: 2011-10-06 Impact factor: 91.245
Authors: Edward H Romond; Edith A Perez; John Bryant; Vera J Suman; Charles E Geyer; Nancy E Davidson; Elizabeth Tan-Chiu; Silvana Martino; Soonmyung Paik; Peter A Kaufman; Sandra M Swain; Thomas M Pisansky; Louis Fehrenbacher; Leila A Kutteh; Victor G Vogel; Daniel W Visscher; Greg Yothers; Robert B Jenkins; Ann M Brown; Shaker R Dakhil; Eleftherios P Mamounas; Wilma L Lingle; Pamela M Klein; James N Ingle; Norman Wolmark Journal: N Engl J Med Date: 2005-10-20 Impact factor: 91.245
Authors: Anthony W Fyles; David R McCready; Lee A Manchul; Maureen E Trudeau; Patricia Merante; Melania Pintilie; Lorna M Weir; Ivo A Olivotto Journal: N Engl J Med Date: 2004-09-02 Impact factor: 91.245
Authors: Kevin S Hughes; Lauren A Schnaper; Jennifer R Bellon; Constance T Cirrincione; Donald A Berry; Beryl McCormick; Hyman B Muss; Barbara L Smith; Clifford A Hudis; Eric P Winer; William C Wood Journal: J Clin Oncol Date: 2013-05-20 Impact factor: 44.544
Authors: David Cameron; Julia Brown; Rebecca Dent; Christian Jackisch; John Mackey; Xavier Pivot; Guenther G Steger; Thomas M Suter; Masakazu Toi; Mahesh Parmar; Rita Laeufle; Young-Hyuck Im; Gilles Romieu; Vernon Harvey; Oleg Lipatov; Tadeusz Pienkowski; Paul Cottu; Arlene Chan; Seock-Ah Im; Peter S Hall; Lida Bubuteishvili-Pacaud; Volkmar Henschel; Regula J Deurloo; Celine Pallaud; Richard Bell Journal: Lancet Oncol Date: 2013-08-07 Impact factor: 41.316
Authors: Joseph A Sparano; Robert J Gray; Della F Makower; Kathleen I Pritchard; Kathy S Albain; Daniel F Hayes; Charles E Geyer; Elizabeth C Dees; Matthew P Goetz; John A Olson; Tracy Lively; Sunil S Badve; Thomas J Saphner; Lynne I Wagner; Timothy J Whelan; Matthew J Ellis; Soonmyung Paik; William C Wood; Peter M Ravdin; Maccon M Keane; Henry L Gomez Moreno; Pavan S Reddy; Timothy F Goggins; Ingrid A Mayer; Adam M Brufsky; Deborah L Toppmeyer; Virginia G Kaklamani; Jeffrey L Berenberg; Jeffrey Abrams; George W Sledge Journal: N Engl J Med Date: 2018-06-03 Impact factor: 91.245