Proton Postmastectomy Radiotherapy ‘Should Be a Treatment Option’ for Breast Cancer, Says Expert

Video

Robert Mutter, MD, of Mayo Clinic says that proton postmastectomy radiation therapy allows for excellent tissue sparing in the management of breast cancer.

Patients should have the option to receive proton postmastectomy radiotherapy for breast cancer when available, according to Robert Mutter, MD, an associate professor of the Department of Radiation Oncology at Mayo Clinic in Rochester, Minnesota.

During the 2022 San Antonio Breast Cancer Symposium (SABCS), CancerNetwork® spoke with Mutter about his work on a randomized phase 2 trial assessing the use of conventional vs hypofractionated proton radiotherapy following a mastectomy among patients with breast cancer.

In the trial, there were no significant differences in terms of 3-year disease-free survival among patients receiving conventional (89.4%; 95% CI, 80.0%-99.8%) or hypofractionated radiotherapy (92.4%; 95% CI, 84.5%–100.0%; P = .91). Mutter also emphasized the importance of gathering additional data to confirm optimal dosing and fractionation.

Transcript:

One of the main takeaways is that this study provides even further evidence that proton therapy for breast cancer provides excellent normal tissue sparing consistent with prior reports. It also appears to provide similar complication rates and similar disease control; there was no difference in disease-free survival between the [conventional and hypofractionated] arms. Our results, again, suggest that proton therapy should be a treatment option for patients at centers that have the proton therapy available.

Our results also suggest that [for] patients being treated with postmastectomy proton therapy, the 3-week 15-fraction course may be a reasonable option provided that fractionation is a part of shared decision-making. We really encourage patients who are being treated with proton therapy who are part of a prospective study or prospective registry, so we can hopefully gain additional information on the optimal dose and fractionation with these efforts in the proton community.

Reference

Mutter R, Giri S, Fruth B, et al. Phase II randomized trial of conventional versus hypofractionated post-mastectomy proton radiotherapy. Presented at the 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX. Abstract GS4-05.

Recent Videos
Although accuracy remains a focus in whole-body MRI testing in patients with Li-Fraumeni syndrome, comfortable testing experiences may ease anxiety.
Subsequent testing among patients in a prospective study may affirm the ability of cfDNA sequencing to detect cancers in those with Li-Fraumeni syndrome.
cfDNA sequencing may allow for more accessible, frequent, and sensitive testing compared with standard surveillance in Li-Fraumeni syndrome.
STX-478 showed efficacy in patients with advanced solid tumors regardless of whether they had kinase domain or helical PI3K mutations.
STX-478 may avoid adverse effects associated with prior PI3K inhibitors that lack selectivity for the mutated protein vs the wild-type protein.
Phase 1 data may show the possibility of rationally designing agents that can preferentially target PI3K mutations in solid tumors.
Funding a clinical trial to further assess liquid biopsy in patients with Li-Fraumeni syndrome may help with detecting cancers early across the board.
Michael J. Hall, MD, MS, FASCO, discusses the need to reduce barriers to care for those with Li-Fraumeni syndrome, including those who live in rural areas.
Patrick Oh, MD, highlights next steps for further research in treating patients with systemic therapy in addition to radiotherapy for early-stage NSCLC.
Related Content