Table 2.

Factors favoring neoadjuvant therapy

• Attacks micrometastases, the primary cause of relapse, at the earliest time

• Preservation of primary tumor and draining nodes can provide an intact immune environment when using checkpoint inhibitors

• Ability to assess sensitivity to agents planned for adjuvant use for individual patients and as part of drug development

• Opportunity to assess remaining tumor cells at maximal response (persisters)

• Ability to assess sensitivity of agents used in induction. You can change the regimen.

• Complete and Major Pathologic Response and outcome surrogate

• Better chemotherapy drug delivery and tolerability

• Better compliance with subsequent therapies

• Time to identify unsuspected metastases and comorbidities before local therapy