The recent trials that were the first to test neoadjuvant immune checkpoint inhibition support this hypothesis by virtue of the extraordinary high pathologic response observed, which was associated with almost no recurrences.
Neoadjuvant therapies provide an unparalleled translational research opportunity to explore gene expression signatures associated with response and to understand molecular mechanisms of resistance. This is a unique opportunity for reverse translation; designing novel experiments utilizing tissue specimens collected at lymph node dissection after neoadjuvant treatment, correlating these results with accurate and homogeneous clinical data, and using this information to select therapies in the clinic or in trials that are more likely to improve patient outcome.