Cancer care is advancing rapidly, and progress relies on collaboration between surgeons, medical oncologists, radiation oncologists, nurses, and research teams. The ORNATE Study (Optimising Radiotherapy after Neoadjuvant Therapy), led by Breast Cancer Trials, represents a new step in understanding radiation therapy use for breast cancer patients.
The ORNATE Study is establishing a prospective registry of women with breast cancer who undergo neoadjuvant therapy (treatment such as chemotherapy before surgery). The registry will collect detailed clinical data, treatment approaches, and patient outcomes across centres in Australia and New Zealand.
Currently, there is significant uncertainty within the radiation oncology community regarding which patients can safely have radiation therapy omitted after achieving a pathologic complete response (pCR) to neoadjuvant therapy. Even after the recent NSABP B-51 trial results, questions remain—particularly around whether all patients with pCR may omit radiation therapy, or whether this is only appropriate for certain tumour subtypes such as HER2-enriched or hormone receptor–negative disease.
By capturing real-world data, the ORNATE registry will provide insights into oncological outcomes, variations and trends in practice, and may eventually incorporate patient-reported outcome measures (PROMs). This information will help clinicians better define who truly benefits from radiation therapy after neoadjuvant therapy, and in turn, refine treatment pathways.
The ORNATE Study underscores how multidisciplinary cancer teams are not only focused on achieving cure, but also on ensuring that treatments are appropriately tailored, evidence-based, and patient-centred.
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