Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Cancer Treat Rev. 2022 Jul;108:102417. doi: 10.1016/j.ctrv.2022.102417. Epub 2022 May 21.
Major advances have been made in precision medicine of breast cancer patients with a series of molecular targeted therapies now in clinical use or in late clinical development. These new therapeutic measures need to be integrated with local treatments, particularly with radiation therapy in both curative and advanced settings. Although a synergistic effect could be obtained between targeted therapies and irradiation, potential safety concerns should be carefully considered. At present, scarce evidence exists due to a lack of quality assurance on radiation therapy in pivotal trials of new drugs and missing reports on safety in case of concurrent radiation therapy, commonly administered with heterogenous doses and fractionations, especially in advanced disease. A major contribution for effectively combining radiation and targeted therapies in breast cancer could derive from clinically relevant preclinical studies. This review integrates preclinical and clinical evidence on how targeted agents and radiation therapy could be combined to help physicians in their daily clinical practice and to improve the clinical management of patients.
在乳腺癌的精准医学方面已经取得了重大进展，一系列分子靶向疗法目前已在临床应用或处于后期临床开发阶段。这些新的治疗措施需要与局部治疗相结合，特别是在根治性和晚期环境中与放射治疗相结合。尽管靶向治疗与放疗之间可能会产生协同作用，但应仔细考虑潜在的安全问题。目前，由于新药物的关键性试验中缺乏对放疗质量保证的证据，并且在同步放疗的情况下缺乏安全性报告，特别是在晚期疾病中，通常使用剂量和分割不均的放疗，因此证据非常有限。通过临床相关的临床前研究，有效地将放疗和靶向治疗相结合可能会做出重大贡献。这篇综述综合了关于靶向药物和放疗如何结合的临床前和临床证据，以帮助医生在日常临床实践中，并改善患者的临床管理。
