For patients with triple negative breast cancer who are planned to receive adjuvant pembrolizumab, would you recommend pembrolizumab be held until radiation is complete?

This will become a practical issue for radiation oncologists as four drugs are now approved for adjuvant treatment after neoadjuvant chemotherapy including pembro, xeloda, T-DM1, and olaparib. Out of these, olaparib and xeloda were done sequential after radiation as concern about increased side effe...

In this article in press, (Bellon et al., PMID 34990776) toxicities were compared in patients receiving concurrent TDM1 versus TH with similar rates of pneumonitis (1.0 vs 0.9%). Small numbers but additional data to support concurrent TDM1, which is what we are standardly doing at our institution.