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Combining Radiation Therapy with Immune Checkpoint Blockadein Breast Cancer

  • Shervin Tabrizi
  • Susan McDuff
  • Alice Y. HoEmail author
Immuno-oncology (S Tolaney, Section Editor)
  • 26 Downloads
Part of the following topical collections:
  1. Topical Collection on Immuno-oncology

Abstract

Purpose of Review

Immune checkpoint blockade (ICB) is an emerging therapy in breast cancer. Its optimal integration with radiation therapy (RT) for breast cancer remains to be established. Herein, we review the current evidence on combining ICB and RT in breast cancer and discuss the challenges, open questions, ongoing trials, and future directions for use of this treatment combination.

Recent Findings

Early trials of ICB in breast cancer show evidence of a modest response, limited due to the low baseline immunogenicity of most breast cancers. RT, as a potent stimulator of the immune system, has been used in combination with ICB with encouraging results. The optimal dose, fractionation, and timing of RT combined with ICB are active areas of investigation. Preclinical evidence suggests that moderate-dose, hypofractionated courses may be more effective at stimulating an immune response than high-dose, single-fraction courses.

Summary

Recent studies suggest that ICB can be active in breast cancer, but optimizing the response rate remains a challenge. The immunostimulatory effects of RT have the potential to overcome this obstacle, with promising data from preclinical and early clinical trials. Future investigation on the optimal dosing and fractionation of RT in combination with ICB will be critical.

Keywords

Immunotherapy Breast cancer Radiation Abscopal effect Checkpoint blockade 

Notes

Compliance with Ethical Standards

Conflict of Interest

Alice Ho reports grants from Tesaro, Inc., and Merck & Co., Inc., outside the submitted work. Shervin Tabrizi and Susan McDuff declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologyMassachusetts General HospitalBostonUSA
  2. 2.Harvard Radiation Oncology ProgramBostonUSA

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