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Review
. 2023 Oct:71:13-21.
doi: 10.1016/j.breast.2023.06.010. Epub 2023 Jul 1.

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

Melanie Machiels  1 , Redouane Oulkadi  2 , Trine Tramm  3 , Shane R Stecklein  4 , Navita Somaiah  5 , Alex De Caluwé  6 , Jonathan Klein  7 , William T Tran  8 , Roberto Salgado  9
Affiliations
Review

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

Melanie Machiels et al. Breast. 2023 Oct.

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.

Keywords: Biomarkers; Breast cancer; Gene expression profile; Genomically adjusted radiation dose; Personalised radiation therapy; Radiation therapy; Response guided therapy; Tumour infiltrating lymphocytes.

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Conflict of interest statement

Declaration of competing interest Roberto Salgado reports non-financial support from Merck and Bristol Myers Squibb (BMS), research support from Merck, Puma Biotechnology and Roche, and personal fees from Roche, BMS and Exact Sciences for advisory boards.

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