Current Panorama and Challenges for Neoadjuvant Cancer Immunotherapy

Immune checkpoint inhibitors (ICI) may overcome cancer cells' ability to evade the immune system and proliferate. The long-term benefit of ICI in the metastatic setting led to evaluate neoadjuvant ICI approaches in several tumor types such as melanoma, non–small cell lung cancer, and breast and bladder cancer. We summarize the current evidence for the efficacy of neoadjuvant ICI in cancer and discuss several unresolved challenges, including the role of adjuvant treatment after neoadjuvant ICI, the efficacy in oncogenic addicted tumors, and standardizing pathologic assessment.