Can you safely proceed with breast irradiation during treatment with immunotherapy?

Topics: Breast Cancer • Radiation Oncology • Medical Oncology • Breast Cancer, Non-metastatic • tnbc

For a node positive, triple negative patient that underwent neoadjuvant chemotherapy followed by breast conservation with a complete pathologic response now receiving immunotherapy, would concurrent radiation be safe to administer to the breast?

Answer from: Radiation Oncologist at Community Practice

In KEYNOTE-522, RT was done with concurrent Pembro after NACT plus IO and no significant additional untoward effect was reported. So, we do RT routinely with Pembro for these patients.

Comments

Radiation Oncologist at Colorado Permanente Medical Group
Are you also okay with 15 fraction PMRT in this se...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
We do use hypofractionation.

Answer from: Radiation Oncologist at Academic Institution

I agree with Dr. @Beriwal's response. In my clinical practice, I also routinely proceed with adjuvant RT during the adjuvant immunotherapy portion of these patients' treatment. I do discuss the exceedingly low risk of radiation pneumonitis with these patients (not outside of my usual clinical practi...

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