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Over the past years, the treatment landscape of breast cancer has significantly evolved. Several new anticancer agents entered clinical use or are in late clinical development. Among them many targeted therapies, including new antibody drug conjugates and immunotherapy agents, have already shown to bring improvements in clinical outcomes, and will therefore likely impact in an increasing manner on the management of breast cancer. The advent of innovative preclinical models has accelerated tumour targets’ identification and subsequent anti-cancer agents’ development, reducing the lag-time between preclinical discoveries and introduction into the clinics. This availability of new therapeutic measures raises the important question on how to integrate them with local and regional treatments, and particularly with radiation therapy, in both curative and advanced settings. The impact of new targeted agents on tumour biology, micro- and immune-environment, and cellular energetics, can alter the clinical outcomes after irradiation.
The purpose of this consensus is to provide preclinical and clinical evidence- and (where lacking) consensus-based guidelines on how to integrate targeted and other agents properly and safely with irradiation to improve the clinical care of patients affected by breast cancer who are candidates for these treatments. An international panel of experts in preclinical and translational research, drug development, and radiation therapy reviewed the available evidence and provide recommendations to help physicians in daily clinical practice.