Neoadjuvant, SBRT With Intratumoural Pembrolizumab Followed by Neoadjuvant Chemotherapy in Breast Cancer

Exclusion Criteria

• •1. Any serious medical comorbidities or other contraindications to radiotherapy, chemotherapy, or surgery (e.g., uncontrolled diabetes, serious heart condition, etc).
• •2. Prior treatment for current breast cancer.
• •3. Previous radiation therapy to the same breast.
• •4. Inflammatory breast carcinoma.
• •5. Invasive mammary carcinoma with sarcomatous, signet cell or metaplastic subtypes.
• •6. Recurrent breast cancer.
• •7. Clinical or radiologic evidence or suspicion of distant metastatic disease (metastatic workup that requires additional imaging to follow-up on suspicious findings will exclude patients).
• •8. Any collagen vascular disease precluding radiotherapy at the discretion of the treating radiation oncologist (particularly lupus, scleroderma, dermatomyositis, psoriatic arthritis).
• •9. No prior stem cell transplantation.
• •10. Any poorly controlled autoimmune conditions.
• •11. Current use of corticosteroids or immunosuppressants.
• •12. Any other malignancy at any site (except non-melanomatous skin cancer) \<5 years prior to study enrollment. Synchronous bilateral breast cancers are acceptable.
• •13. Inability to tolerate core needle biopsies or pembrolizumab injection.
• •14. Pregnant or lactating.
• •15. Under 18 years of age.
• •16. Inability or unwillingness to provide informed consent.
• •17. Inability or unwillingness to complete study assessments/interventions and follow-up assessments.