Individualising radiation therapy decisions in breast cancer patients based on tumour-infiltrating lymphocytes and genomic biomarkers

BJMO - volume 17, issue 6, october 2023

M. Machiels MD, PhD, R. Oulkadi MD, T. Tramm MD, PhD, S.R. Stecklein MD, PhD, N. Somaiah MD, PhD, A. De Caluwé MD, J. Klein MD, PhD, W.T. Tran MD, PhD, R. Salgado MD, PhD


Radiation therapy (RT) has long been fundamental for the curative treatment of breast cancer. While substantial progress has been made in the anatomical and technological precision of RT delivery, and some approaches to de-escalate or omit RT based on clinic-pathologic features have been successful, there remain substantial opportunities to refine individualised RT based on tumour biology. A major area of clinical and research interest is to ascertain the individualised risk of loco-regional recurrence to direct treatment decisions regarding escalation and de-escalation of RT. Patient-tailored treatment with RT is considerably lagging behind compared with the massive progress made in the field of personalised medicine that currently mainly applies to decisions on the use of systemic therapy or targeted agents.

Herein we review select literature surrounding the use of tumour genomic biomarkers and biomarkers of the immune system, including tumour-infiltrating lymphocytes (TILs), within the management of breast cancer, specifically as they relate to progress in moving toward analytically validated and clinically tested biomarkers utilised in RT.

(Belg J Med Oncol 2023;17(6):216–29)

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