Dr Champ on the Consideration of Using Radiation Therapy in Breast Cancer

Colin E. Champ, MD, radiation oncologist, Allegheny Health Network, discusses the importance of considering the use of radiation therapy for patients with breast cancer and details ongoing research into this arena.

In recent years, oncologists have launched several studies to evaluate patients that may forego radiation therapy based on their low-risk pathologic features of pathology, Champ begins. One such trial launched was the PRIME-II study (ISRCTN95889329), which was conducted in patients with early breast cancer, evaluating breast-conserving surgery with or without irradiation. Investigators noted a 10% risk of recurrence at 10 years and a 1% to 2% risk of recurrence at 10 years in patients who underwent received a lumpectomy and radiation therapy, Champ explains. Notably, similar numbers were observed across other trials investigating this topic, varying in patients with higher-risk features, Champ adds.

However, these investigations are mainly looking at pathology and staging, creating a large push for genomic testing. Genomic testing is encouraged to understand if investigators can produce a score that indicates whether there will be individual benefit from radiation therapy or not, Champ expands. Based on these needs, investigators launched a meta-analysis of 3 large studies, conducting testing on to garner a Profile for the Omission of Local Adjuvant Radiotherapy (POLAR) score. It was found that it was Data showed that this score was a stronger predictor of radiation benefit than the typical pathologic features that would be assessed we would look at, Champ explains.

Because this was not a randomized study, some clinicians will argue that it is not yet ready for primetime, Champ continues. As time goes on, more of these tests will continue to come down the pipeline, answering the question of whether radiation therapy is needed or not, as well as what benefit would be added, Champ notes.