One of the things that is coming out of this ASCO is the idea that in the past we have used chemotherapy response to guide adjuvant treatment decisions for women with breast cancer. How women respond to chemotherapy or how their tumors respond to chemotherapy up front has been very important in identifying who’s going to do particularly well and have a lower risk of their cancer recurring, who is at higher or elevated risk of their cancer recurring, and that has guided how we’ve treated them after they’ve completed surgery and chemotherapy...
One of the things that is coming out of this ASCO is the idea that in the past we have used chemotherapy response to guide adjuvant treatment decisions for women with breast cancer. How women respond to chemotherapy or how their tumors respond to chemotherapy up front has been very important in identifying who’s going to do particularly well and have a lower risk of their cancer recurring, who is at higher or elevated risk of their cancer recurring, and that has guided how we’ve treated them after they’ve completed surgery and chemotherapy. The idea being proposed by a number of groups here at ASCO this year is that radiation can similarly be used as a response biomarker. That is, we can give radiation up front, look at how the tumor responds in the first one to three weeks, and that may inform whether we need to treat with higher doses of radiation or in exceptional responders, maybe we can de-escalate therapy. We could de-escalate surgery, perhaps less radiation therapy, perhaps smaller treatment fields, perhaps all with the idea of avoiding morbidity of treatment, whether it be chemotherapy or radiation therapy in patients who have a good prognosis, good response to therapy, and in women who unfortunately don’t have a great response to therapy, how can we appropriately escalate therapy in ways to make their survival better and improve their quality of life and their length of life as well? So there’s a lot that came out at ASCO 2026 that answered that question. The NEO check ray study is about to be published. The TBCRC 053 trial or the PRAD trial asked that question, can we use radiation to make immune checkpoint blockade or immunotherapy work better? The data suggests that actually can be true. And so the next five to 10 years will be a lot of efforts put into trying to identify how do we sequence radiation, chemotherapy, immunotherapy, and ways to make responses even better for women.
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