American Medical Association (AMA)
JAMA Oncology
,  volume 11 ,  issue 3 ,  pages 329

Biomarker-Directed Radiotherapy in Breast Cancer

Icro Meattini 1, 2
, 
Charlotte E Coles 3
, 
Trine Tramm 4, 5
, 
Simona Borghesi 6
, 
David Krug 7
, 
Angel Montero 8, 9
, 
Valerio Nardone 10
, 
Viola Salvestrini 2
, 
Marianna Valzano 2
, 
Vincenzo Valentini 11
, 
Cynthia Aristei 12, 13
, 
Philip Poortmans 14, 15
, 
Meritxell Arenas 16
, 
Liesbeth J Boersma 16
, 
Yasemin Bolukbasi 16
, 
Antonella Ciabattoni 16
, 
Pierfrancesco Franco 16
, 
Domenico Genovesi 16
, 
Orit Kaidar Person 16
, 
Vassilis Kouloulias 16
, 
Marco Krengli 16
, 
Maria Cristina Leonardi 16
, 
Laura Lozza 16
, 
Fabio Marazzi 16
, 
Valeria Masiello 16
, 
Alessio G. Morganti 16
, 
Birgitte Offersen 16
, 
Isabella Palumbo 16
, 
Sara Pedretti 16
, 
Elisabetta Perrucci 16
, 
Ivica Ratosa 16
, 
Sofia Rivera 16
, 
Maria de Lurdes Garcia Trigo 16
1
 
2
 
3
 
4
 
5
 
6
 
Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Arezzo, Italy | 
7
 
8
 
Department of Radiation Oncology, HM Hospitales, Madrid, Spain | 
9
 
10
 
11
 
Centro Eccellenza Oncologia e Diagnostica per Immagini, Ospedale Isola Tiberina–Gemelli Isola, Rome, Italy | 
12
 
13
 
14
 
Department of Radiation Oncology, Iridium Netwerk, Wilrijk-Antwerp, Belgium | 
15
 
16
 
for the Assisi Think Tank Meeting Investigators
Publication type: Journal Article
Publication date: 2025-03-01
American Medical Association (AMA)
scimago Q1
wos Q1
SJR: 8.377
CiteScore: 32.6
Impact factor: 20.1
ISSN: 23742437, 23742445
Abstract
Importance

Integration of molecular biomarker information into systemic therapy has become standard practice in breast cancer care. However, its implementation in guiding radiotherapy (RT) is slower. Although postoperative RT is recommended for most patients after breast-conserving surgery and, depending on risk factors, following mastectomy, emerging evidence has indicated that patients with low scores on gene expression signatures or selected clinical-pathological features may have very low local recurrence rates. This narrative review explored the potential of biomarker-directed personalized RT approaches, which may optimize treatment strategies and be associated with improved patient outcomes and experiences.

Observations

Distinctions between prognostic and predictive biomarkers were highlighted, emphasizing the importance of analytical and clinical validity in biomarker-based studies. Findings from studies investigating the prognostic and predictive value of various genomic signatures and immunohistochemical markers for guiding breast RT were presented. These included the Adjuvant Radiotherapy Intensification Classifier and the Profile for the Omission of Local Adjuvant Radiation, which have shown potential in predicting RT benefits. The genomic-adjusted radiation dose and role of tumor-infiltrating lymphocytes were also discussed. Ongoing clinical trials exploring the use of biomarkers in ductal carcinoma in situ and invasive breast cancer to refine RT decision-making were illustrated.

Conclusions and Relevance

The results of this narrative review suggest that evidence-based shared decision-making is crucial to optimize treatment according to the individual’s predicted benefits and risks along with their personal preferences. Incorporation of biomarker-directed approaches in RT for breast cancer may hold promise for personalized treatment, potentially facilitating omission of RT for patients at low risk of recurrence, while identifying those who may benefit from intensified therapy. This personalized RT approach may be associated with improved clinical outcomes and quality of life and facilitate decision-making for people with breast cancer. However, there remains a need for robust clinical and analytical validation of biomarkers to ensure reliability and clinical utility for RT optimization.

Found 
Found 

Top-30

Journals

1
Archives of Gynecology and Obstetrics
Archives of Gynecology and Obstetrics, 1, 11.11%
Archives of Gynecology and Obstetrics
1 publication, 11.11%
Breast
Breast, 1, 11.11%
Breast
1 publication, 11.11%
Cancers
Cancers, 1, 11.11%
Cancers
1 publication, 11.11%
The Lancet Oncology
The Lancet Oncology, 1, 11.11%
The Lancet Oncology
1 publication, 11.11%
Geburtshilfe und Frauenheilkunde
Geburtshilfe und Frauenheilkunde, 1, 11.11%
Geburtshilfe und Frauenheilkunde
1 publication, 11.11%
American Society of Clinical Oncology Educational Book
American Society of Clinical Oncology Educational Book, 1, 11.11%
American Society of Clinical Oncology Educational Book
1 publication, 11.11%
Senologie - Zeitschrift für Mammadiagnostik und -therapie
Senologie - Zeitschrift für Mammadiagnostik und -therapie, 1, 11.11%
Senologie - Zeitschrift für Mammadiagnostik und -therapie
1 publication, 11.11%
Biomedicines
Biomedicines, 1, 11.11%
Biomedicines
1 publication, 11.11%
International Journal of Radiation Oncology Biology Physics
International Journal of Radiation Oncology Biology Physics, 1, 11.11%
International Journal of Radiation Oncology Biology Physics
1 publication, 11.11%
1

Publishers

1
2
3
Elsevier
Elsevier, 3, 33.33%
Elsevier
3 publications, 33.33%
MDPI
MDPI, 2, 22.22%
MDPI
2 publications, 22.22%
Georg Thieme Verlag KG
Georg Thieme Verlag KG, 2, 22.22%
Georg Thieme Verlag KG
2 publications, 22.22%
Springer Nature
Springer Nature, 1, 11.11%
Springer Nature
1 publication, 11.11%
American Society of Clinical Oncology (ASCO)
American Society of Clinical Oncology (ASCO), 1, 11.11%
American Society of Clinical Oncology (ASCO)
1 publication, 11.11%
1
2
3
  • We do not take into account publications without a DOI.
  • Statistics recalculated weekly.

Are you a researcher?

Create a profile to get free access to personal recommendations for colleagues and new articles.
Metrics
9
Share
Cite this
GOST |
Cite this
GOST Copy
Meattini I. et al. Biomarker-Directed Radiotherapy in Breast Cancer // JAMA Oncology. 2025. Vol. 11. No. 3. p. 329.
GOST all authors (up to 50) Copy
Meattini I., Coles C. E., Tramm T., Borghesi S., Krug D., Montero A., Nardone V., Salvestrini V., Valzano M., Valentini V., Aristei C., Poortmans P., Arenas M., Boersma L. J., Bolukbasi Y., Ciabattoni A., Franco P., Genovesi D., Kaidar Person O., Kouloulias V., Krengli M., Leonardi M. C., Lozza L., Marazzi F., Masiello V., Morganti A. G., Offersen B., Palumbo I., Pedretti S., Perrucci E., Ratosa I., Rivera S., Garcia Trigo M. D. L. Biomarker-Directed Radiotherapy in Breast Cancer // JAMA Oncology. 2025. Vol. 11. No. 3. p. 329.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1001/jamaoncol.2024.5780
UR - https://jamanetwork.com/journals/jamaoncology/fullarticle/2829034
TI - Biomarker-Directed Radiotherapy in Breast Cancer
T2 - JAMA Oncology
AU - Meattini, Icro
AU - Coles, Charlotte E
AU - Tramm, Trine
AU - Borghesi, Simona
AU - Krug, David
AU - Montero, Angel
AU - Nardone, Valerio
AU - Salvestrini, Viola
AU - Valzano, Marianna
AU - Valentini, Vincenzo
AU - Aristei, Cynthia
AU - Poortmans, Philip
AU - Arenas, Meritxell
AU - Boersma, Liesbeth J
AU - Bolukbasi, Yasemin
AU - Ciabattoni, Antonella
AU - Franco, Pierfrancesco
AU - Genovesi, Domenico
AU - Kaidar Person, Orit
AU - Kouloulias, Vassilis
AU - Krengli, Marco
AU - Leonardi, Maria Cristina
AU - Lozza, Laura
AU - Marazzi, Fabio
AU - Masiello, Valeria
AU - Morganti, Alessio G.
AU - Offersen, Birgitte
AU - Palumbo, Isabella
AU - Pedretti, Sara
AU - Perrucci, Elisabetta
AU - Ratosa, Ivica
AU - Rivera, Sofia
AU - Garcia Trigo, Maria de Lurdes
PY - 2025
DA - 2025/03/01
PB - American Medical Association (AMA)
SP - 329
IS - 3
VL - 11
SN - 2374-2437
SN - 2374-2445
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2025_Meattini,
author = {Icro Meattini and Charlotte E Coles and Trine Tramm and Simona Borghesi and David Krug and Angel Montero and Valerio Nardone and Viola Salvestrini and Marianna Valzano and Vincenzo Valentini and Cynthia Aristei and Philip Poortmans and Meritxell Arenas and Liesbeth J Boersma and Yasemin Bolukbasi and Antonella Ciabattoni and Pierfrancesco Franco and Domenico Genovesi and Orit Kaidar Person and Vassilis Kouloulias and Marco Krengli and Maria Cristina Leonardi and Laura Lozza and Fabio Marazzi and Valeria Masiello and Alessio G. Morganti and Birgitte Offersen and Isabella Palumbo and Sara Pedretti and Elisabetta Perrucci and Ivica Ratosa and Sofia Rivera and Maria de Lurdes Garcia Trigo},
title = {Biomarker-Directed Radiotherapy in Breast Cancer},
journal = {JAMA Oncology},
year = {2025},
volume = {11},
publisher = {American Medical Association (AMA)},
month = {mar},
url = {https://jamanetwork.com/journals/jamaoncology/fullarticle/2829034},
number = {3},
pages = {329},
doi = {10.1001/jamaoncol.2024.5780}
}
MLA
Cite this
MLA Copy
Meattini, Icro, et al. “Biomarker-Directed Radiotherapy in Breast Cancer.” JAMA Oncology, vol. 11, no. 3, Mar. 2025, p. 329. https://jamanetwork.com/journals/jamaoncology/fullarticle/2829034.