Immunotherapy is increasingly being used before or after surgery for a variety of cancers. Researchers at Karolinska Institutet have reviewed studies across seven tumor areas, revealing a trend toward earlier treatment approaches.
For years, immunotherapy has transformed the treatment of advanced cancers that are no longer surgically removable. Now, it’s being used more frequently in earlier stages of disease, both before and after operations.
A scientific article from Karolinska Institutet summarizes studies of several different cancer diagnoses, grouped into seven tumor areas: skin cancer, lung cancer, breast cancer, gastrointestinal cancer, gynecological cancer, head and neck cancer, and urological cancer.
“We are seeing that immunotherapy in early stages of disease is rapidly evolving in many tumor areas,” said Hildur Helgadottir, a researcher at Karolinska Institutet. “By compiling studies from many types of cancer, it becomes clearer how the field is moving and what experiences can be shared between different specialties.”
Immunotherapy Can Increase Effectiveness
Several studies demonstrate that immunotherapy following surgery, known as adjuvant treatment, can reduce the risk of cancer recurrence. Other research indicates that neoadjuvant treatment – administering the medication even as the tumor is still present – often gives the immune system better conditions to recognize cancer cells. This approach to treatment is gaining traction as a way to improve patient outcomes.
Across several tumor areas, results suggest that immunotherapy given both before and after surgery may offer greater benefits than treatment after surgery alone. Although, researchers emphasize that the effect varies between different cancer types and that treatment can present challenges, including the risk of side effects and the possibility that some patients may receive more treatment than necessary if surgery alone would have been sufficient.
Collaboration Across Multiple Areas
The article is a collaboration between 14 researchers at the Department of Oncology-Pathology at Karolinska Institutet, all of whom are as well involved in cancer treatment within the healthcare system. The researchers’ representation from seven different tumor areas allows for the consolidation of experiences from many parts of cancer care.
“It is valuable that we have come together from so many different tumor areas,” Helgadottir said. “It provides a broader understanding of how immunotherapy is used in different parts of cancer care and can, in the long run, support both clinical decisions and future research.”
More Knowledge is Needed
Researchers also highlight areas where more knowledge is needed, including the development of biomarkers – measurable characteristics that can help healthcare providers determine which patients will benefit from immunotherapy, both before and after surgery.
Immunotherapy in early stages of disease also raises questions about costs, side effects, and how healthcare resources will be sufficient – questions that current studies do not yet fully answer. The increasing use of immunotherapy underscores the need for continued research and careful consideration of resource allocation within healthcare systems.
Scientific Article:
Perioperative immune checkpoint inhibitor therapy across tumors: Insights and shared lessons from a rapidly evolving field, Journal of Internal Medicine.
