Dr Jimenez on the Radiation Treatment Paradigm in Breast Cancer

Rachel Jimenez, MD, chair, Quality and Safety, Department of Radiation Oncology, Massachusetts General Hospital, associate professor, Radiation Oncology, Harvard Medical School, discusses unmet needs in radiation treatment for patients with breast cancer.

, Jimenez highlighted recent updates in radiation oncology, as well as the importance of personalized treatment. Jimenez begins by stating that in the realm of radiation therapy, the traditional treatment approach has been to apply a somewhat standardized dose regimen for patients with breast cancer. However, there's a growing realization that, similar to systemic therapy, radiation treatment can be customized to better suit individual patients, she states, adding that this entails delivering appropriate doses to specific areas for each patient. Although there's still progress to be made before these tailored approaches can be fully implemented into clinical practice, efforts are underway to identify which patients truly require radiation and to determine the optimal dosage for each case, Jimenez explains.

Currently, several clinical trials are underway utilizing established genomic signatures, which are commonly used in clinical settings to guide systemic therapy decisions, to assist in determining whether certain patients can safely forgo radiation treatment, Jimenez expands. Although definitive data outside of these trials are limited, there is considerable interest in and ongoing recruitment to these trials, she elucidates. Additionally, emerging radio signatures are designed specifically to assess the efficacy of radiation therapy, radio says. Although these radio signatures are increasingly being integrated into clinical trials, they are still in the early stages of development and not yet ready for widespread adoption, Jimenez highlights.

Despite these advancements, unmet needs remain in this area, she continues. Although progress in radio signatures has been made, further validation through clinical trials is necessary to accurately determine which patients would benefit most from specific radiation doses and techniques, Jimenez concludes.

Videos

Rachel Jimenez, MD, discusses unmet needs in radiation treatment for patients with breast cancer.


Rachel Jimenez, MD, the chair of Quality and Safety in the Department of Radiation Oncology at Massachusetts General Hospital, discusses the management of toxicities associated with radiotherapy for patients with breast cancer.

During the 2022 San Antonio Breast Cancer Symposium, Jimenez presented on the current state of radiotherapy in breast cancer, including ways to reduce toxicities and novel options for administering radiation.

When patients with breast cancer require radiotherapy, there are concerns regarding toxicity to surrounding tissue, including muscles, ribs, heart, and lungs. The shoulder, thyroid, and esophagus can also be affected, depending on the area being treated with radiation. To understand ways to reduce toxicity to surrounding tissue for these patients, clinicians must examine ways this tissue can receive less radiation exposure, no radiation exposure, or less detrimental radiation exposure, Jimenez says.

Novel technologies could help improve the therapeutic ratio of radiation for patients with breast cancer while mitigating toxicities to normal tissue. Proton therapy has the potential to help spare normal tissue, Jimenez says. In proton therapy, a proton dose is deposited in the form of a Bragg peak, with a sharp fall-off distal to the peak of the dose, reducing the exit dose beyond the distal tumor edge relative to the beam approach to decrease low-dose radiation to normal tissue.

Proton therapy is a form of radiation that can be targeted in a specific way to prevent low-dose radiation from affecting normal tissue that is not intended for exposure to radiation. For example, when women receive radiation to the left side of their body, proton therapy could help spare the heart from exposure to radiation.

Ongoing clinical trials are exploring proton therapy in patients with breast cancer, particularly for patients with advanced breast cancer who may be at risk of having more cardiac exposure to radiation, Jimenez concludes.

Rachel Jimenez, MD, discusses the management of toxicities associated with radiotherapy for patients with breast cancer.

Rachel Jimenez, MD

Articles

Dr Jimenez on the Radiation Treatment Paradigm in Breast Cancer

Dr. Jimenez on the Management of Radiation Toxicities in Breast Cancer