Neoadjuvant immunotherapy of locoregionally advanced solid tumors
Definitive management of locoregionally advanced solid tumors presents a major challenge and often consists of a combination of surgical, radiotherapeutic and systemic therapy approaches. Upfront surgical treatment with or without adjuvant radiotherapy carries the risks of significant morbidities an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-08-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/10/8/e005036.full |
| _version_ | 1811214768582688768 |
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| author | John Wright Patrick M Forde Robert L Ferris Ahmad A Tarhini Kathleen N Moore Jennifer R Eads Valerie Tatard-Leitman |
| author_facet | John Wright Patrick M Forde Robert L Ferris Ahmad A Tarhini Kathleen N Moore Jennifer R Eads Valerie Tatard-Leitman |
| author_sort | John Wright |
| collection | DOAJ |
| description | Definitive management of locoregionally advanced solid tumors presents a major challenge and often consists of a combination of surgical, radiotherapeutic and systemic therapy approaches. Upfront surgical treatment with or without adjuvant radiotherapy carries the risks of significant morbidities and potential complications that could be lasting. In addition, these patients continue to have a high risk of local or distant disease relapse despite the use of standard adjuvant therapy. Preoperative neoadjuvant systemic therapy has the potential to significantly improve clinical outcomes, particularly in this era of expanding immunotherapeutic agents that have transformed the care of patients with metastatic/unresectable malignancies. Tremendous progress has been made with neoadjuvant immunotherapy in the treatment of several locoregionally advanced resectable solid tumors leading to ongoing phase 3 trials and change in clinical practice. The promise of neoadjuvant immunotherapy has been supported by the high pathologic tumor response rates in early trials as well as the durability of these responses making cure a more achievable potential outcome compared with other forms of systemic therapy. Furthermore, neoadjuvant studies allow the assessment of radiologic and pathological responses and the access to biospecimens before and during systemic therapy. Pathological responses may guide future treatment decisions, and biospecimens allow the conduct of mechanistic and biomarker studies that may guide future drug development. On behalf of the National Cancer Institute Early Drug Development Neoadjuvant Immunotherapy Working Group, this article summarizes the current state of neoadjuvant immunotherapy of solid tumors focusing primarily on locoregionally advanced melanoma, gynecologic malignancies, gastrointestinal malignancies, non-small cell lung cancer and head and neck cancer including recent advances and our expert recommendations related to future neoadjuvant trial designs and associated clinical and translational research questions. |
| first_indexed | 2024-04-12T06:10:09Z |
| format | Article |
| id | doaj.art-0837f91f0af34ef39b6c5c784cd6e2a9 |
| institution | Directory Open Access Journal |
| issn | 2051-1426 |
| language | English |
| last_indexed | 2024-04-12T06:10:09Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj.art-0837f91f0af34ef39b6c5c784cd6e2a92022-12-22T03:44:44ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262022-08-0110810.1136/jitc-2022-005036Neoadjuvant immunotherapy of locoregionally advanced solid tumorsJohn Wright0Patrick M Forde1Robert L Ferris2Ahmad A Tarhini3Kathleen N Moore4Jennifer R Eads5Valerie Tatard-Leitman6Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UKBloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USAUPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USACutaneous Oncology, Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USAAff2 Stephenson Oklahoma Cancer Center Oklahoma City OK USAMedicine, University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania, USAThe Emmes Company LLC, Rockville, Maryland, USADefinitive management of locoregionally advanced solid tumors presents a major challenge and often consists of a combination of surgical, radiotherapeutic and systemic therapy approaches. Upfront surgical treatment with or without adjuvant radiotherapy carries the risks of significant morbidities and potential complications that could be lasting. In addition, these patients continue to have a high risk of local or distant disease relapse despite the use of standard adjuvant therapy. Preoperative neoadjuvant systemic therapy has the potential to significantly improve clinical outcomes, particularly in this era of expanding immunotherapeutic agents that have transformed the care of patients with metastatic/unresectable malignancies. Tremendous progress has been made with neoadjuvant immunotherapy in the treatment of several locoregionally advanced resectable solid tumors leading to ongoing phase 3 trials and change in clinical practice. The promise of neoadjuvant immunotherapy has been supported by the high pathologic tumor response rates in early trials as well as the durability of these responses making cure a more achievable potential outcome compared with other forms of systemic therapy. Furthermore, neoadjuvant studies allow the assessment of radiologic and pathological responses and the access to biospecimens before and during systemic therapy. Pathological responses may guide future treatment decisions, and biospecimens allow the conduct of mechanistic and biomarker studies that may guide future drug development. On behalf of the National Cancer Institute Early Drug Development Neoadjuvant Immunotherapy Working Group, this article summarizes the current state of neoadjuvant immunotherapy of solid tumors focusing primarily on locoregionally advanced melanoma, gynecologic malignancies, gastrointestinal malignancies, non-small cell lung cancer and head and neck cancer including recent advances and our expert recommendations related to future neoadjuvant trial designs and associated clinical and translational research questions.https://jitc.bmj.com/content/10/8/e005036.full |
| spellingShingle | John Wright Patrick M Forde Robert L Ferris Ahmad A Tarhini Kathleen N Moore Jennifer R Eads Valerie Tatard-Leitman Neoadjuvant immunotherapy of locoregionally advanced solid tumors Journal for ImmunoTherapy of Cancer |
| title | Neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| title_full | Neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| title_fullStr | Neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| title_full_unstemmed | Neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| title_short | Neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| title_sort | neoadjuvant immunotherapy of locoregionally advanced solid tumors |
| url | https://jitc.bmj.com/content/10/8/e005036.full |
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