Expert Consensus on the Combined Application of Radiotherapy and Novel Systemic Agents in Breast Cancer Treatment

The rapid advancement of radiotherapy techniques and systemic anticancer agents has created unprecedented opportunities to improve outcomes for breast cancer patients, while also introducing new challenges related to optimal integration and safety. This consensus, convened by the Breast Cancer Committee of the Chinese Anti-Cancer Association and Chinese Society of Clinical Oncology Breast Cancer Committee, systematically evaluated available literature through November 2025 and employed Delphi methodology to generate evidence-based recommendations for combining radiotherapy with immune checkpoint inhibitors, targeted therapies, antibody-drug conjugates and endocrine agents across disease stages. This work aims to guide clinicians toward safer and more effective integration of radiotherapy with contemporary systemic treatments, promote consistency in clinical practice, and identify priority directions for future research to refine precision radiotherapy and systemic therapy combinations in breast cancer.