Perioperative immune checkpoint inhibitor therapy across tumors: Insights and shared lessons from a rapidly evolving field - PubMed
8 days ago
- #immune checkpoint inhibitors
- #neoadjuvant therapy
- #adjuvant therapy
- Perioperative immune checkpoint inhibitor therapy is transforming curative-intent oncology.
- Neoadjuvant immunotherapy shows biological advantages by exposing the immune system to intact tumor antigens, improving event-free survival and pathological response rates.
- Notable successes include CheckMate 816 in NSCLC and KEYNOTE-522 in TNBC, with superior outcomes compared to adjuvant-only approaches.
- Pathological complete response and major pathological response are robust surrogate endpoints correlating with long-term survival.
- Adjuvant immunotherapy results are more variable, with inconsistent overall survival advantages and risks of overtreatment.
- Challenges include the absence of predictive biomarkers, immune-related adverse events in up to 30% of patients, high healthcare costs, and insufficient OS follow-up.
- Future priorities include biomarker development, adaptive trial designs, and long-term toxicity assessment.
- Optimal patient selection, treatment sequencing, and safety optimization are essential for widespread implementation.