The promise of neoadjuvant immunotherapy and surgery for cancer treatment.

The promise of neoadjuvant immunotherapy and surgery for cancer treatment. Clin Cancer Res. 2019 Apr 30;: Authors: O'Donnell JS, Hoefsmit EP, Smyth MJ, Blank CU, Teng MWL Abstract Cancer immunotherapies utilizing immune checkpoint inhibitors (ICIs) have demonstrated durable efficacy in a proportion of patients with advanced/metastatic cancers. More recently, the use of ICIs for the adjuvant treatment of patients with surgically resectable melanoma have also demonstrated efficacy by improving relapse-free survival and in the case of ipilimumab (anti-CTLA-4) also improving overall survival. While promising, the effective scheduling of surgery and immunotherapy and its duration is not well elucidated. Recent preclinical studies suggest that surgery followed by adjuvant therapy might be suboptimal as compared to an approach in which immunotherapy is applied before surgery (neoadjuvant immunotherapy). Encouraging findings from early phase clinical trials in melanoma, NSCLC and glioblastoma support the idea that neoadjuvant immunotherapy might have improved clinical efficacy over an adjuvant application. In this review we discuss the existing rationale for the use of neoadjuvant immunotherapy, its apparent strengths, weaknesses, and implications for the design of future clinical trials. PMID: 31040150 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research