Another field of great interest is the new possibility in combining immunotherapeutic drugs with radiation therapy. Again, traditionally radiation therapy has been considered immunosuppressive but this was depending from the large size of the volume of the body irradiated and also the use of conventional fractionation. What has been recently discovered is that reducing the volume of the treatment by means of specialised techniques like radiosurgery, like stereotactic body irradiation, and increasing the daily dose to 8Gy or more we are able to create a stimulation of the immune system because this technique and this dose are able to damage the tumour and to put in the microenvironment a sort of many new antigens that can be recognised by drugs like immune checkpoint inhibitors that can be activated against this path.

How do you think this will impact future breast cancer treatments? 

The future is to move more in this field and we have to learn to use radiation therapy not in the traditional way but exactly as a drug with different doses, different schedules, new doses and new schedules. I believe that this may be a great option in order to increase our capability to treat and to cure most patients.