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Pre-operative Radiation and Immunotherapy in the Treatment of Non-metastatic Breast Cancer

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Abstract

Purpose of Review

To discuss the rationale and latest strategies for combining pre-operative radiation therapy (pre-op RT) and immunotherapy (IO) in the treatment of non-metastatic breast cancer.

Recent Findings

IO has recently been incorporated into the standard-of-care treatment for patients with stage II–III triple-negative breast cancer. Other subtypes of breast cancer have notably been excluded from most major IO trials due to their perceived lack of immunogenicity, though oncologic outcomes for all high-risk patients warrant further improvement. Early-phase clinical trials have demonstrated the feasibility of pre-op RT. There is a sound pre-clinical basis for the combination of pre-op RT and IO to induce robust local and systemic anti-tumor immunomodulation in patients with all types of breast cancer.

Summary

There is emerging interest in utilizing pre-op RT to prime the anti-tumor immune response and potentially promote an abscopal effect when combined with IO. Trials investigating various combinations of pre-op RT and IO are underway.

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Data Availability

Not applicable.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Radiation Oncology, Duke University Medical Center, 30 Duke Medicine Circle, Box 3085, Durham, NC, 27710, USA

    Pooja Karukonda, Alice Y. Ho & Susan McDuff

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  1. Pooja Karukonda
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  2. Alice Y. Ho
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  3. Susan McDuff
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Contributions

P. K., A. H., and S. M. wrote the main manuscript text. P. K., A. H., and S. M. prepared the tables and figure. All authors reviewed the manuscript.

Corresponding author

Correspondence to Susan McDuff.

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Conflict of Interest

Drs. Karukonda and McDuff declare that they have no conflict of interest. Dr. Ho has received research support and consulting fees from Merck, research support from GSK, and consulting fees from La Roche Posay and serves on the advisory board for La Roche Posay.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Karukonda, P., Ho, A.Y. & McDuff, S. Pre-operative Radiation and Immunotherapy in the Treatment of Non-metastatic Breast Cancer. Curr Breast Cancer Rep 15, 213–221 (2023). https://doi.org/10.1007/s12609-023-00507-0

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