Research progress on the application of combining radiotherapy and systemic therapy in breast cancer

doi:10.3760/cma.j.cn371439-20230404-00072

Abstract

Abstract:

Compared with single therapy，radiotherapy combined with chemotherapy，endocrine therapy，molecular targeted therapy and immunological therapy can not only shorten the treatment cycle，but also improve the local control rate and prolong the survival of patients. However，the safety of combined therapy still needs to be further clarified to comprehensively evaluate the feasibility. Therefore，exploring the efficacy and safety of radiotherapy combined with systematic therapy will provide evidence for clinical benefits.

Key words: Breast neoplasms, Radiotherapy, Drug therapy, combination, Molecular targeted therapy, Immunotherapy

Li Qingshan, Xie Xin, Zhang Nan, Liu Shuai. Research progress on the application of combining radiotherapy and systemic therapy in breast cancer[J]. Journal of International Oncology, 2023, 50(6): 362-367.

References 43

[1]	Aumeeruddy MZ, Mahomoodally MF. Combating breast cancer using combination therapy with 3 phytochemicals: piperine, sulforaphane, and thymoquinone[J]. Cancer, 2019, 125(10): 1600-1611. DOI: 10.1002/cncr.32022. doi: 10.1002/cncr.32022 pmid: 30811596
[2]	Zhou ZR, Yang ZZ, Yu XL, et al. Highlights on molecular targets for radiosensitization of breast cancer cells: current research status and prospects[J]. Cancer Med, 2018, 7(7): 3110-3117. DOI: 10.1002/cam4.1588. doi: 10.1002/cam4.1588
[3]	Ciérvide R, Montero Á, García-Rico E, et al. Primary chemoradiotherapy treatment (PCRT) for HER2⁺ and triple negative breast cancer patients: a feasible combination[J]. Cancers (Basel), 2022, 14(18): 4531. DOI: 10.3390/cancers14184531. doi: 10.3390/cancers14184531
[4]	Iyer P, Radhakrishnan V, Balasubramanian A, et al. Study of pathological complete response rate with neoadjuvant concurrent chemoradiation with paclitaxel in locally advanced breast cancer[J]. Indian J Cancer, 2020, 57(4): 428-434. DOI: 10.4103/ijc.IJC_524_19. doi: 10.4103/ijc.IJC_524_19
[5]	Fernando IN, Bowden SJ, Herring K, et al. Synchronous versus sequential chemo-radiotherapy in patients with early stage breast cancer (SECRAB): a randomised, phase Ⅲ, trial[J]. Radiother Oncol, 2020, 142: 52-61. DOI: 10.1016/j.radonc.2019.10.014. doi: 10.1016/j.radonc.2019.10.014
[6]	Fernando IN, Lax S, Bowden SJ, et al. Detailed sub-study analysis of the SECRAB trial: quality of life, cosmesis and chemotherapy dose intensity[J]. Clin Oncol (R Coll Radiol), 2023, 35(6): 397-407. DOI: 10.1016/j.clon.2023.03.007. doi: 10.1016/j.clon.2023.03.007 pmid: 37012180
[7]	Ahmed S, M Kamal S, Salah T, et al. Concurrent capecitabine with external beam radiotherapy versus radiotherapy alone in painful bone metastasis of breast cancer origin[J]. J Bone Oncol, 2021, 31: 100395. DOI: 10.1016/j.jbo.2021.100395. doi: 10.1016/j.jbo.2021.100395
[8]	Cai G, Cao L, Kirova YM, et al. Prospective results of concurrent radiation therapy and weekly paclitaxel as salvage therapy for unresectable locoregionally recurrent breast cancer[J]. Radiat Oncol, 2019, 14(1): 115. DOI: 10.1186/s13014-019-1321-1. doi: 10.1186/s13014-019-1321-1 pmid: 31266510
[9]	Naumann FV, Sweep FCGJ, Adema GJ, et al. Tamoxifen induces radioresistance through NRF2-mediated metabolic reprogramming in breast cancer[J]. Cancer Metab, 2023, 11(1): 3. DOI: 10.1186/s40170-023-00304-4. doi: 10.1186/s40170-023-00304-4 pmid: 36755288
[10]	Anzic M, Marinko T. Effect of adjuvant hormonal therapy on the development of pulmonary fibrosis after postoperative radiotherapy for breast cancer[J]. J Breast Cancer, 2020, 23(5): 449-459. DOI: 10.4048/jbc.2020.23.e48. doi: 10.4048/jbc.2020.23.e48 pmid: 33154822
[11]	Elkiki SM, Mansour HH, Anis LM, et al. Evaluation of aromatase inhibitor on radiation induced pulmonary fibrosis via TGF-β/Smad 3 and TGF-β/PDGF pathways in rats[J]. Toxicol Mech Methods, 2021, 31(7): 538-545. DOI: 10.1080/15376516.2021.1934765. doi: 10.1080/15376516.2021.1934765
[12]	Chargari C, Castro-Pena P, Toledano I, et al. Concurrent use of aromatase inhibitors and hypofractionated radiation therapy[J]. World J Radiol, 2012, 4(7): 318-323. DOI: 10.4329/wjr.v4.i7.318. doi: 10.4329/wjr.v4.i7.318 pmid: 22900133
[13]	Yavas G, Yavas C, Acar H, et al. Comparison of the effects of aromatase inhibitors and tamoxifen on radiation-induced lung toxicity: results of an experimental study[J]. Support Care Cancer, 2013, 21(3): 811-817. DOI: 10.1007/s00520-012-1584-7. doi: 10.1007/s00520-012-1584-7 pmid: 22941118
[14]	Wang J, Yang Q, Haffty BG, et al. Fulvestrant radiosensitizes human estrogen receptor-positive breast cancer cells[J]. Biochem Biophys Res Commun, 2013, 431(2): 146-151. DOI: 10.1016/j.bbrc.2013.01.006. doi: 10.1016/j.bbrc.2013.01.006
[15]	Ding J, Guo Y, Jiang X, et al. Concomitant fulvestrant with reirradiation for unresectable locoregional recurrent estrogen receptor positive (ER⁺) breast cancer: a case report and narrative review[J]. Medicine (Baltimore), 2020, 99(30): e21344. DOI: 10.1097/MD.0000000000021344. doi: 10.1097/MD.0000000000021344
[16]	Belgioia L, Desideri I, Errico A, et al. Safety and efficacy of combined radiotherapy, immunotherapy and targeted agents in elderly patients: a literature review[J]. Crit Rev Oncol Hematol, 2019, 133: 163-170. DOI: 10.1016/j.critrevonc.2018.11.009. doi: S1040-8428(18)30241-5 pmid: 30661652
[17]	Beddok A, Cottu P, Fourquet A, et al. Combination of modern radiotherapy and new targeted treatments for breast cancer management[J]. Cancers (Basel), 2021, 13(24): 6358. DOI: 10.3390/cancers13246358. doi: 10.3390/cancers13246358
[18]	De Santis MC, Bonfantini F, Di Salvo F, et al. Trastuzumab and hypofractionated whole breast radiotherapy: a victorious combination?[J]. Clin Breast Cancer, 2018, 18(3): e363-e371. DOI: 10.1016/j.clbc.2017.08.011. doi: 10.1016/j.clbc.2017.08.011
[19]	Aboudaram A, Loap P, Loirat D, et al. Pertuzumab and trastuzumab combination with concomitant locoregional radiotherapy for the treatment of breast cancers with HER2 receptor overexpression[J]. Cancers (Basel), 2021, 13(19): 4790. DOI: 10.3390/cancers13194790. doi: 10.3390/cancers13194790
[20]	Lah TT, Novak M, Breznik B. Brain malignancies: glioblastoma and brain metastases[J]. Semin Cancer Biol, 2020, 60: 262-273. DOI: 10.1016/j.semcancer.2019.10.010. doi: S1044-579X(19)30227-5 pmid: 31654711
[21]	Stemmler HJ, Schmitt M, Willems A, et al. Ratio of trastuzumab levels in serum and cerebrospinal fluid is altered in HER2-positive breast cancer patients with brain metastases and impairment of blood-brain barrier[J]. Anticancer Drugs, 2007, 18(1): 23-28. DOI: 10.1097/01.cad.0000236313.50833.ee. doi: 10.1097/01.cad.0000236313.50833.ee
[22]	Mignot F, Kirova Y, Verrelle P, et al. In vitro effects of trastuzumab emtansine (T-DM1) and concurrent irradiation on HER2-positive breast cancer cells[J]. Cancer Radiother, 2021, 25(2): 126-134. DOI: 10.1016/j.canrad.2020.06.028. doi: 10.1016/j.canrad.2020.06.028 pmid: 33431297
[23]	Stumpf PK, Cittelly DM, Robin TP, et al. Combination of trastuzumab emtansine and stereotactic radiosurgery results in high rates of clinically significant radionecrosis and dysregulation of aquaporin-4[J]. Clin Cancer Res, 2019, 25(13): 3946-3953. DOI: 10.1158/1078-0432.CCR-18-2851. doi: 10.1158/1078-0432.CCR-18-2851 pmid: 30940654
[24]	Dastgheyb SS, Kim K, Doucette A, et al. Acute skin radiation toxicity seen with concurrent T-DM1: a single institutional report of 35 patients[J]. Breast, 2023, 67: 26-29. DOI: 10.1016/j.breast.2022.12.002. doi: 10.1016/j.breast.2022.12.002
[25]	Parsai S, Miller JA, Juloori A, et al. Stereotactic radiosurgery with concurrent lapatinib is associated with improved local control for HER2-positive breast cancer brain metastases[J]. J Neurosurg, 2019, 132(2): 503-511. DOI: 10.3171/2018.10.JNS182340. doi: 10.3171/2018.10.JNS182340 pmid: 30738402
[26]	Kim JM, Miller JA, Kotecha R, et al. Stereotactic radiosurgery with concurrent HER2-directed therapy is associated with improved objective response for breast cancer brain metastasis[J]. Neuro Oncol, 2019, 21(5): 659-668. DOI: 10.1093/neuonc/noz006. doi: 10.1093/neuonc/noz006
[27]	Huang T, Luo X, Wu B, et al. Pyrotinib enhances the radiosensitivity of HER2‑overexpressing gastric and breast cancer cells[J]. Oncol Rep, 2020, 44(6): 2634-2644. DOI: 10.3892/or.2020.7820. doi: 10.3892/or.2020.7820 pmid: 33125154
[28]	Anwar M, Chen Q, Ouyang D, et al. Pyrotinib treatment in patients with HER2-positive metastatic breast cancer and brain metastasis: exploratory final analysis of real-world, multicenter data[J]. Clin Cancer Res, 2021, 27(16): 4634-4641. DOI: 10.1158/1078-0432.CCR-21-0474. doi: 10.1158/1078-0432.CCR-21-0474 pmid: 34112711
[29]	Lin Y, Lin M, Zhang J, et al. Real-world data of pyrotinib-based therapy in metastatic HER2-positive breast cancer: promising efficacy in lapatinib-treated patients and in brain metastasis[J]. Cancer Res Treat, 2020, 52(4): 1059-1066. DOI: 10.4143/crt.2019.633. doi: 10.4143/crt.2019.633
[30]	Kanthou C, Tozer G. Targeting the vasculature of tumours: combi-ning VEGF pathway inhibitors with radiotherapy[J]. Br J Radiol, 2019, 92(1093): 20180405. DOI: 10.1259/bjr.20180405. doi: 10.1259/bjr.20180405
[31]	Dautruche A, Belin L, Cottu P, et al. Evaluation at 3 years of concurrent bevacizumab and radiotherapy for breast cancer: results of a prospective study[J]. Cancer Radiother, 2018, 22(3): 222-228. DOI: 10.1016/j.canrad.2017.10.004. doi: S1278-3218(18)30044-1 pmid: 29650388
[32]	Chen YL, Huang AP, Wang CC, et al. Peri-radiosurgical administration of bevacizumab improves radiographic response to single and fractionated stereotactic radiosurgery for large brain metastasis[J]. J Neurooncol, 2021, 153(3): 455-465. DOI: 10.1007/s11060-021-03782-y. doi: 10.1007/s11060-021-03782-y
[33]	Clément-Zhao A, Tanguy ML, Cottu P, et al. Toxicity of locoregional radiotherapy in combination with bevacizumab in patients with non-metastatic breast cancer (TOLERAB): final long-term evaluation[J]. PLoS One, 2019, 14(8): e0221816. DOI: 10.1371/journal.pone.0221816. doi: 10.1371/journal.pone.0221816
[34]	Pesch AM, Hirsh NH, Chandler BC, et al. Short-term CDK4/6 inhibition radiosensitizes estrogen receptor-positive breast cancers[J]. Clin Cancer Res, 2020, 26(24): 6568-6580. DOI: 10.1158/1078-0432.CCR-20-2269. doi: 10.1158/1078-0432.CCR-20-2269 pmid: 32967938
[35]	Guerini AE, Pedretti S, Salah E, et al. A single-center retrospective safety analysis of cyclin-dependent kinase 4/6 inhibitors concurrent with radiation therapy in metastatic breast cancer patients[J]. Sci Rep, 2020, 10(1): 13589. DOI: 10.1038/s41598-020-70430-2. doi: 10.1038/s41598-020-70430-2 pmid: 32788596
[36]	Beddok A, Xu HP, Henry AA, et al. Concurrent use of palbociclib and radiation therapy: single-centre experience and review of the literature[J]. Br J Cancer, 2020, 123(6): 905-908. DOI: 10.1038/s41416-020-0957-9. doi: 10.1038/s41416-020-0957-9
[37]	Michmerhuizen AR, Pesch AM, Moubadder L, et al. PARP1 inhibition radiosensitizes models of inflammatory breast cancer to ionizing radiation[J]. Mol Cancer Ther, 2019, 18(11): 2063-2073. DOI: 10.1158/1535-7163.MCT-19-0520. doi: 10.1158/1535-7163.MCT-19-0520 pmid: 31413177
[38]	Jagsi R, Griffith KA, Moran JM, et al. A randomized comparison of radiation therapy techniques in the management of node-positive breast cancer: primary outcomes analysis[J]. Int J Radiat Oncol Biol Phys, 2018, 101(5): 1149-1158. DOI: 10.1016/j.ijrobp.2018.04.075. doi: 10.1016/j.ijrobp.2018.04.075
[39]	Jagsi R, Griffith KA, Bellon JR, et al. Concurrent veliparib with chest wall and nodal radiotherapy in patients with inflammatory or locoregionally recurrent breast cancer: the TBCRC 024 phase Ⅰ multicenter study[J]. J Clin Oncol, 2018, 36(13): 1317-1322. DOI: 10.1200/JCO.2017.77.2665. doi: 10.1200/JCO.2017.77.2665
[40]	Loap P, Loirat D, Berger F, et al. Combination of olaparib with radiotherapy for triple-negative breast cancers: one-year toxicity report of the RADIOPARP phase Ⅰ trial[J]. Int J Cancer, 2021, 149(10): 1828-1832. DOI: 10.1002/ijc.33737. doi: 10.1002/ijc.33737
[41]	王欢, 蒋海萍, 高源, 等. 抗PD-1/PD-L1免疫治疗生物标志物研究进展[J]. 国际肿瘤学杂志, 2019, 46(1): 40-44. DOI: 10.3760/cma.j.issn.1673-422X.2019.01.009. doi: 10.3760/cma.j.issn.1673-422X.2019.01.009
[42]	Voorwerk L, Slagter M, Horlings HM, et al. Immune induction strategies in metastatic triple-negative breast cancer to enhance the sensitivity to PD-1 blockade: the TONIC trial[J]. Nat Med, 2019, 25(6): 920-928. DOI: 10.1038/s41591-019-0432-4. doi: 10.1038/s41591-019-0432-4 pmid: 31086347
[43]	Barroso-Sousa R, Krop IE, Trippa L, et al. A phase Ⅱ study of pembrolizumab in combination with palliative radiotherapy for hormone receptor-positive metastatic breast cancer[J]. Clin Breast Cancer, 2020, 20(3): 238-245. DOI: 10.1016/j.clbc.2020.01.012. doi: S1526-8209(20)30028-8 pmid: 32113750