Neoadjuvant or perioperative immunotherapy in oncology: A new paradigm shift

Neoadjuvant or perioperative immunotherapy, either alone or in combination with other antineoplastic agents (e.g., chemotherapy), has been shown to improve long-term outcomes across several cancers. The potential for early-phase immune priming is promising and has been associated with improvements in multiple immunologic and clinical endpoints. Melanoma and other skin cancers, triple-negative breast cancer, non-small cell lung cancer (NSCLC), genitourinary cancers, and rectal cancer are among the clinical settings being reshaped by the advent of perioperative and neoadjuvant immunotherapy.More recently, neoadjuvant and perioperative immunotherapy has been evaluated in phase II and phase III clinical trials, showing potential benefits across different tumor types. In MSI-H rectal cancer, immunotherapy has been shown to achieve high rates of pathologic complete response (pCR), in some cases eliminating the need for further locoregional therapy.In clinically stage III melanoma, neoadjuvant immunotherapy has demonstrated superior efficacy compared with adjuvant treatment alone. It is emerging as a promising strategy that may allow de-escalation of surgical procedures and subsequent adjuvant therapies. In early-stage and locally advanced NSCLC, immunotherapy—either as adjuvant treatment after radical resection or in combination with chemotherapy in neoadjuvant or perioperative settings—has significantly improved survival.Early administration of immunotherapy could change treatment algorithms in oncology and support de-escalation strategies, with potential benefits for quality of life (QoL). This Research Topic warrants further investigation and review to support physicians in clinical decision-making. In addition, multidisciplinary care teams must consider this option alongside its organizational impact on patient management. Prognostic and predictive factors are urgently needed in this clinical setting.In this Research Topic, we invite authors to:- Review clinical data on neoadjuvant or perioperative immunotherapy across different diseases. - Discuss potential predictive and prognostic factors, including biomarkers, that may support clinical decision-making in the near future. - Explore future developments in neoadjuvant or perioperative immunotherapy. - Discuss organizational models for patient management within the framework of a multidisciplinary tumor board.Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this Research Topic.Topic Editor Alessandro Minisini declares having received funding resources from Regeneron (advisory board, principal investigator in clinical triale), MSD (advisory board, travel grant) and BMS (advisory board, travel grant).Topic Editor Andrea Boutros declares having received speaker honoraria from BMS, MSD, SunPharma, Regeneron and Immunocore. Topic editors: Alessandro Minisini, Maria Grazia Vitale, Andrea Boutros Source: https://www.frontiersin.org/research-topics/77744/neoadjuvant-or-perioperative-immunotherapy-in-oncology-a-new-paradigm-shift