Preoperative immunotherapy in oncology

作者：Ralf‐Dieter Hofheinz, Sylvie Lorenzen, M. Sebastian, Servet Bölükbas, Stefan Fichtner‐Feigl, Sibylle Loibl · 发表于：Deutsches Ärzteblatt international · 年份：2026 · DOI：10.3238/arztebl.m2025.0209 · 被引用次数：1 · 研究领域：Cancer, Stress, Anesthesia, and Immune Response、Cancer Immunotherapy and Biomarkers、Inflammatory Biomarkers in Disease Prognosis

BACKGROUND: Immune checkpoint inhibitors (ICI) are in standard use for the treatment of many kinds of metastatic tumor. Their use before surgery to prolong event-free and overall survival (EFS, OS) has been studied in recent years. METHODS: This review is based on clinically relevant studies published since 2018 on the preoperative use of ICI for four tumor entities: breast cancer, non-small cell lung cancer (NSCLC), colorectal cancer, and esophagogastric adenocarcinoma. The studies were identified by a selective search in PubMed. In addition, abstracts from international conference presentations were evaluated. RESULTS: The approved, standard perioperative treatment of triple-negative breast cancer of stage IIa and above is with durvalumab (an ICI) combined with chemotherapy for one year. This improved the 5-year EFS by 9% (81.2% vs. 72.2%; HR = 0.65) and the overall survival rate by 5% (86.6% vs. 81.7%; HR = 0.66). In NSCLC, the addition of an ICI to preoperative chemotherapy increased 2-year EFS by approximately 11% in stage II or III (63.3% vs. 52.4%; HR = 0.68), according to the largest trial that has been published to date. The addition of durvalumab to perioperative chemotherapy for stage II or III esophagogastric adenocarcinoma increased the 2-year EFS by 8% (67% vs. 59%; HR = 0.71). Approval for this indication is expected. In colorectal carcinoma with microsatellite instability, neoadjuvant ICI therapy for 1-6 months often led to clinical and/or histological complet...