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Latest Research in Breast Cancer

Across the world, radiation oncologists are actively researching safe and effective radiation treatments, including more personalized approaches and studies of lower doses for a variety of cancers. The following research studies were presented during the ASTRO Annual Meeting in October 2020. Annually, ASTRO hosts the largest gathering of radiation oncology professionals in the world to share the latest science and research, all designed to improve patient care, support clinical practice and advance science and research in the field of radiation oncology.

The information provided below highlights the research provided in the studies included in the Best of ASTRO onDemand course. This information is not intended as medical advice. It is important to review and discuss all treatment options, including radiation therapy with your primary care physician before determining which option or combination of options is best for you and your lifestyle.

Studies in Breast Cancer

Discussant: Rachel Blitzblau, MD, PhD
Patient Takeaways prepared by Rachel Blitzblau, MD, PhD, and Jolinta Lin, MD

Several studies looked at alternative fractionation schemes for breast cancer radiation therapy (RT):

  • For early-stage breast cancers:
    • Accelerated partial breast RT to the tumor bed using twice daily fractions of 4 Gy in 8 treatments to 32 Gy showed effective treatment, lower rates of toxicities and better cosmetic outcome at 10 years of follow-up compared to higher doses per fraction (#25: Tagian et al.)
    • Alternative fractionations using simultaneous integrated lumpectomy cavity boost during whole breast RT in the IMRT-MCE2 and HYPOSIB trials demonstrated comparable local control outcomes and cosmesis compared to conventionally fractionated whole breast RT with boost (#19: Hörner-Rieber et al. & 24: Krug et al.)
  • For HER2+ breast cancers:
    • An analysis of the HERA trial showed that HER2-positive patients who completed locoregional therapy, chemotherapy and HER2-directed therapy had excellent rates of local control regardless of whether or not a lumpectomy cavity boost was delivered; however, the authors advise that this decision should be studied in future randomized studies (#52, Zeidan et al.).
  • For patients requiring post-mastectomy RT in the setting of reconstruction surgery:
    • A phase II trial consisting of hypofractionated chest wall and regional nodal irradiation is safe and effective with similar outcomes of reconstruction failures compared to those reported in literature from conventionally fractionated post-mastectomy RT (#20: Yehia et al.).

Two studies focused on treatment toxicities:

  • Green tea extract, epigallocatechin-3-gallate (EGCG), may be effective in decreasing high grade skin irritation during post mastectomy RT compared to patients who received placebo (#22: Zhu et al).
  • A prediction model calculating acute coronary events after breast RT showed the large impact of pre-existing comorbid conditions in increasing the risk of cardiac events (#21: Spoor et al.).

For patients who convert from node positive disease to node negative disease after neoadjuvant chemotherapy:

  • A pooled analysis of four large prospective trials suggests that patients with residual disease in the breast had worse survival and higher rates of disease recurrence compared to those who had no residual disease in the breast; the authors caution against omitting regional nodal RT off clinical trial in this setting (#49: Mailhot et al).
Download the PDF of the Best of ASTRO Patient Takeaways
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