Journal
CURRENT BREAST CANCER REPORTS
Volume -, Issue -, Pages -Publisher
SPRINGER
DOI: 10.1007/s12609-023-00506-1
Keywords
Neoadjuvant chemotherapy; Breast cancer; Radiation; Regional nodal irradiation; Radiation omission
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Personalizing adjuvant radiotherapy based on response to neoadjuvant chemotherapy is a goal that is currently being evaluated in multiple clinical trials, including NSABP B-51.
Purpose of ReviewNeoadjuvant chemotherapy (NAC) utilization is an important part of breast cancer therapy. Recent advances call into question the optimal role of radiotherapy after NAC, as many radiation studies were performed without NAC. This review was conducted to understand the current data, outstanding questions and ongoing trials related to radiotherapy after NAC.Recent FindingsResponse to NAC is associated with promising clinical outcomes, particularly in triple-negative and HER2+ breast cancer. Retrospective data suggest that modification of radiotherapy based on tumor response to NAC may be appropriate, though caution is advised without prospective randomized evidence. NSABP B-51 and Alliance A011202 will investigate the management of nodal disease in this setting. Future trials will examine the optimal sequencing of treatments.SummaryThe personalization of adjuvant radiotherapy based on response to neoadjuvant chemotherapy is an attractive goal that is currently being evaluated in multiple clinical trials, including NSABP B-51.
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