Concurrent Chemoradiotherapy for Locally Advanced Breast Cancer—Time for a New Paradigm?

Abstract

Background: In cases of locally advanced breast cancer (labc), preoperative (“neoadjuvant”) therapy was traditionally reserved to render the patient operable. More recently, neoadjuvant therapy, particularly chemotherapy, is being used in patients with operable disease to increase the opportunity for breast conservation. Despite the increasing use of preoperative chemotherapy, rates of pathologic complete response, a surrogate marker for disease-free survival, remain modest in patients with locally advanced disease and particularly so when the tumour is estrogen or progesterone receptor–positive and her2-negative. A new paradigm for labc patients is needed. In other solid tumours (for example, rectal, esophageal, and lung cancers), concurrent chemoradiotherapy (ccrt) is routinely used in neoadjuvant and adjuvant treatment protocols alike. Results: The literature suggests that ccrt in labc patients with inoperable disease is associated with response rates higher than would be anticipated with systemic therapy alone. Conclusions: Ongoing trials in this field are eagerly awaited to determine if ccrt should become the new paradigm.

Circulating Small EVs miRNAs as Predictors of Pathological Response to Neo-Adjuvant Therapy in Breast Cancer Patients

“…Treatment response represents one of the most significant issues of BC management, since about 30% of BC patients develop resistance to the standard therapeutic scheme, leading to cancer progression and decreased survival [ 31 ]. Locally advanced BC patients are subjected to neo-adjuvant therapy in order to reduce the tumor size and improve the surgical decision (the ability to choose breast-conserving surgery) as well as a method for assessing the patient’s response to systemic therapy [ 32 ]. Recent data suggest that pathological complete response (pCR) after NAT is associated with better patient prognosis [ 6 ].…”

Preclinical models of radiation-induced cardiac toxicity: Potential mechanisms and biomarkers

“…The use of concurrent chemotherapy and radiotherapy (cCRT) against a variety of solid tumors, such as esophageal, breast, and non-small cell lung cancer (NSCLC) has been a promising strategy for the synergistic enhancement of local and distal tumor control, which in many cases has been translated into survival benefits ( 178 – 182 ). Moreover, numerous preclinical studies have also described that the combination of chemotherapeutic agents with radiotherapy could be a promising strategy for synergistic enhancement of treatment efficacy ( 183 , 184 ).…”

Alterações Dermatológicas Durante Tratamento Oncológico de Mulheres com Câncer de Mama: Estudo em Prontuários Clínicos

“…O avanço nas terapias do câncer de mama demonstra que a associação entre a quimioterapia e a terapia com radiação ionizante tem demonstrado bons resultados na redução da mortalidade. Em estágios avançados da doença, a utilização dessa modalidade pode trazer desfechos mais favoráveis para tumores inoperáveis, viabilizando a abordagem cirúrgica 29 . Entretanto, ambas as modalidades provocam alterações dermatológicas que demandam de cuidados durante o tratamento oncológico.…”