The Prognostic and Predictive Value of Genomic Assays in Guiding Adjuvant Breast Radiation Therapy

Abstract

Many patients with non-metastatic breast cancer benefit from adjuvant radiation therapy after lumpectomy or mastectomy on the basis of many randomized trials. However, there are many patients that have such low risks of recurrence after surgery that de-intensification of therapy by either reducing the treatment volume or omitting radiation altogether may be appropriate options. On the other hand, dose intensification may be necessary for more aggressive breast cancers. Until recently, these treatment decisions were based solely on clinicopathologic factors. Here, we review the current literature on the role of genomic assays as prognostic and/or predictive biomarkers to help guide adjuvant radiation therapy decision-making.

Individualising radiation therapy decisions in breast cancer patients based on tumour infiltrating lymphocytes and genomic biomarkers

“…At least three of the published profiles show a connection between benefit from RT and the immune response [ 25 , 27 , 28 ]. Two recently published reviews dive deeper into this matter [ 29 , 30 ].…”