Radiotherapy and radiosensitization in breast cancer: Molecular targets and clinical applications

Vasudeva Bhat; Sierra Pellizzari; Alison L Allan; Eugene Wong; Michael Lock; Muriel Brackstone; Ana Elisa Lohmann; David W Cescon; Armen Parsyan

doi:10.1016/j.critrevonc.2021.103566

Radiotherapy and radiosensitization in breast cancer: Molecular targets and clinical applications

Crit Rev Oncol Hematol. 2022 Jan:169:103566. doi: 10.1016/j.critrevonc.2021.103566. Epub 2021 Dec 7.

Authors

Vasudeva Bhat¹, Sierra Pellizzari², Alison L Allan³, Eugene Wong⁴, Michael Lock⁵, Muriel Brackstone⁶, Ana Elisa Lohmann⁵, David W Cescon⁷, Armen Parsyan⁸

Affiliations

¹ London Regional Cancer Program, London Health Science Centre, London, ON, N6A 5W9, Canada; Department of Anatomy & Cell Biology, Western University, London, ON, N6A 3K7, Canada.
² Department of Anatomy & Cell Biology, Western University, London, ON, N6A 3K7, Canada.
³ London Regional Cancer Program, London Health Science Centre, London, ON, N6A 5W9, Canada; Department of Anatomy & Cell Biology, Western University, London, ON, N6A 3K7, Canada; Department of Oncology, Western University, London, ON, N6A 4L6, Canada.
⁴ Department of Oncology, Western University, London, ON, N6A 4L6, Canada; Department of Physics and Astronomy, Western University, London, ON, N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, N6A 5C1, Canada.
⁵ London Regional Cancer Program, London Health Science Centre, London, ON, N6A 5W9, Canada; Department of Oncology, Western University, London, ON, N6A 4L6, Canada.
⁶ London Regional Cancer Program, London Health Science Centre, London, ON, N6A 5W9, Canada; Department of Oncology, Western University, London, ON, N6A 4L6, Canada; Department of Surgery, Western University, London, ON, N6A 3K7, Canada.
⁷ Department of Medical Oncology and Hematology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
⁸ London Regional Cancer Program, London Health Science Centre, London, ON, N6A 5W9, Canada; Department of Anatomy & Cell Biology, Western University, London, ON, N6A 3K7, Canada; Department of Oncology, Western University, London, ON, N6A 4L6, Canada; Department of Surgery, Western University, London, ON, N6A 3K7, Canada. Electronic address: aparsyan@uwo.ca.

PMID: 34890802
DOI: 10.1016/j.critrevonc.2021.103566

Abstract

Relatively poor survival outcomes are observed in advanced or metastatic breast cancer, where local control of the primary or metastatic disease may be achieved by surgical resection, local ablative and radiation therapies. Radioresistance, poses a major challenge in achieving durable oncologic outcomes, mandating development of novel management strategies. Although multimodality approaches that combine radiotherapy with chemotherapy, or systemic agents, are utilized for radiosensitization and treatment of various malignancies, this approach has not yet found its clinical application in breast cancer. Some agents for breast cancer treatment can serve as radiosensitizers, creating an opportunity to enhance effects of radiation while providing systemic disease control. Hence, combination of radiotherapy with radiosensitizing agents have the potential to improve oncologic outcomes in advanced or metastatic breast cancer. This review discusses molecular targets for radiosensitization and novel systemic agents that have potential for clinical use as radiosensitizers in breast cancer.

Keywords: Breast cancer; Chemotherapy; Combination therapy; Radioresistance; Radiosensitizers; Radiotherapy.

Publication types

Review

MeSH terms

Breast Neoplasms* / drug therapy
Breast Neoplasms* / radiotherapy
Female
Humans
Radiation-Sensitizing Agents* / therapeutic use

Substances

Radiation-Sensitizing Agents