Personalisation of radiotherapy for breast cancer

The role of radiotherapy is well established in the multidisciplinary management of breast cancer. However, its use could be customised further with the intent of enhancing tumour cell radiosensitisation and reducing normal cell toxicity. The importance of tumour heterogeneity and the microenvironment in the response to radiotherapy is under intense scrutiny and the value of molecular profiling is being increasingly recognised. Genome Wide Association Studies are likely to
play an important role in elucidating the molecular pathogenesis of radiotoxicity in the emerging area of radiogenomics. Biomarkers of tumour radiosensitivity should help indicate potentially responsive and unresponsive cancers. Further understanding of the tumour microenvironment and better preclinical models will help identify targets to enhance radiosensitivity or reverse radioresistance.