International multidisciplinary consensus on the integration of radiotherapy with new systemic treatments for breast cancer: European Society for Radiotherapy and Oncology (ESTRO)-endorsed recommendations

Meattini, Icro; Becherini, Carlotta; Caini, Saverio; Coles, Charlotte E; Cortes, Javier; Curigliano, Giuseppe; de Azambuja, Evandro; Isacke, Clare M; Harbeck, Nadia; Kaidar-Person, Orit; Marangoni, Elisabetta; Offersen, Birgitte V; Rugo, Hope S; Salvestrini, Viola; Visani, Luca; Morandi, Andrea; Lambertini, Matteo; Poortmans, Philip; Livi, Lorenzo; Alkner, Sara; Bhattacharya, Indrani S.; Boersma, Liesbeth; Callari, Maurizio; Clarke, Robert B.; Del Mastro, Lucia; Ekholm, Maria; Gennari, Alessandra; Kirby, Anna M.; Kroeze, Stephanie; Malumbres, Marcos; Vestmø Maraldo, Maja; Marta, Gustavo Nader; Mjaaland, Ingvil; Morgan, Gilberto; Pistilli, Barbara; Paluch-Shimon, Shani; Rivera, Sofia; Rottenberg, Sven; Saura, Cristina; Skyttä, Tanja; Spanic, Tanja

doi:10.1016/s1470-2045(23)00534-x

Cited by 11 publications

(4 citation statements)

References 74 publications

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“…Pooled data from 68 prospective trials involving immune checkpoint inhibitors suggested that the administration of these drugs within 90 days after radiotherapy did not seem to increase the risk of serious AEs [26]. The European Society for Radiotherapy and Oncology recently published a multidisciplinary expert consensus on the integration of RT with drugs [27], with 95% of the experts agreeing on the concurrent delivery of Pembrolizumab and RT.…”

Section: Discussionmentioning

confidence: 99%

Safety of pembrolizumab with concurrent radiotherapy in early stage breast cancer: preliminary prospective real-world evidence

Colciago,

Presti,

Giandini

et al. 2024

Preprint

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INTRODUCTION Data on the feasibility and potential synergy of concomitant immunotherapy with radiation therapy (RT) is still scarce for early breast cancer (BC). We aimed to assess the safety profile of adjuvant pembrolizumab with concomitant radiotherapy (RT) in breast cancer patients. MATERIAL AND METHODS: We prospectively collected data from ten patients with triple-negative breast cancer treated with neoadjuvant chemotherapy with pembrolizumab (as per Keynote-522 criteria) followed by surgery and at least 1 cycle of adjuvant pembrolizumab with concomitant RT. A total dose of 40.05 Gy delivered in 15 fractions was prescribed to the breast or chest wall, with regional nodes and tumor bed boost administered as clinically indicated. The study endpoint was to assess acute toxicity according to the Radiation Therapy Oncology Group scale, and to report the rate of discontinuation of RT and/or pembrolizumab. RESULTS A median of 8 (range 4 – 9) cycles of neoadjuvant Pembrolizumab were prescribed. Before RT, patients received a median of 3 (range 2 – 4) cycles of adjuvant Pembrolizumab. Severe acute toxicity occurred in 2 patients. Specifically, G4 myositis led to permanent discontinuation of adjuvant pembrolizumab in one case, whereas G3 electrolyte imbalance caused definitive RT interruption and temporary discontinuation of adjuvant pembrolizumab in the second case. Among the remaining 8 patients, only 2 patients experienced G2 skin erythema with no treatment discontinuation. CONCLUSIONS The combination of adjuvant pembrolizumab with concurrent radiotherapy proved feasible in the real world, as toxicity was minimal and consistent with existing literature.

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Section: Discussionmentioning

confidence: 99%

Safety of pembrolizumab with concurrent radiotherapy in early stage breast cancer: preliminary prospective real-world evidence

Colciago,

Presti,

Giandini

et al. 2024

Preprint

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“…Interesting reports have been published on combined radiation and ChT such as cisplatin, 5-FU, docetaxel or vinorelbine. Further evaluation of the benefit of combining radiation with a PARP inhibitor is ongoing in a prospective trial in patients with LABC or metastatic TNBC and in non-responders to primary ChT [ [150] , [151] , [152] ].…”

Section: Methodsmentioning

confidence: 99%

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Cardoso,

Paluch-Shimon,

Schumacher-Wulf

et al. 2024

The Breast

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“…Additionally, the role and optimization of radiotherapy in breast cancer treatment protocols remain critical [ 21 ]. Radiotherapy is a cornerstone of breast cancer management, used both in the early and more advanced stages of this disease [ 22 ]. Innovations in radiotherapy techniques aim to increase the precision and effectiveness of radiation delivery, minimize damage to surrounding healthy tissues, and enhance its cancer-killing capabilities [ 23 , 24 ].…”

Section: Advancing Frontlines: New Perspectives In Breast Cancer Rese...mentioning

confidence: 99%

Bridging Discoveries and Treatments: The New Landscape of Breast Cancer Research

Hu,

Wang,

Autelli

et al. 2024

Life

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International multidisciplinary consensus on the integration of radiotherapy with new systemic treatments for breast cancer: European Society for Radiotherapy and Oncology (ESTRO)-endorsed recommendations

Cited by 11 publications

References 74 publications

Safety of pembrolizumab with concurrent radiotherapy in early stage breast cancer: preliminary prospective real-world evidence

Safety of pembrolizumab with concurrent radiotherapy in early stage breast cancer: preliminary prospective real-world evidence

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Bridging Discoveries and Treatments: The New Landscape of Breast Cancer Research

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