Use pre-surgery immunotherapy windows as the field's biomarker engine
Giving immunotherapy for a few weeks before surgery produces a tumour sample that shows exactly what the drug did. That is the fastest way to learn who responds.
Neoadjuvant window trials deliver paired baseline and post-treatment tissue plus a pathological response readout within weeks, and they have already produced high-quality mechanistic insight in melanoma, colorectal cancer with mismatch repair deficiency and bladder cancer. Standardising a shared window protocol across tumour types, with common tissue handling and open data release, would turn scattered studies into a systematic discovery platform.
- No one can predict who responds to immunotherapy · Checkpoint drugs cure some patients and do nothing for most. We still cannot tell the two apart before treating.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
- Failures are hidden · Negative trials, failed drugs and abandoned programmes are rarely published, so the same mistakes are repeated.
Pages like this
not linked directly; found by shared links- Key paperNICHE-2: a month of nivolumab and ipilimumab before surgery clears mismatch-repair-deficient colon cancer in most patients
Shares Myriam Chalabi, Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, No one can predict who responds to immunotherapy.
- Key paperNICHE-2: a single dose of ipilimumab and two of nivolumab before surgery clears dMMR colon cancer in most patients
Shares Myriam Chalabi, NICHE-2, Pathologic complete response (pCR), Trial design, endpoints and cost.
- Key paperNADINA: two doses of ipilimumab plus nivolumab before surgery beat a year of nivolumab after surgery in stage III melanoma
Shares Christian Blank, Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, Trial design, endpoints and cost.
- IdeaPre-surgery platform trials that test combinations on pathological response in months
Shares Major pathological response (MPR), NADINA, Pathologic complete response (pCR), Trial design, endpoints and cost.
- PairingNeoadjuvant immunotherapy → response-adapted adjuvant
Shares Major pathological response (MPR), NADINA, Melanoma, Immune checkpoint inhibitors.
- Key paperNIAGARA: durvalumab before and after cystectomy for muscle-invasive bladder cancer
Shares Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, No one can predict who responds to immunotherapy, Trial design, endpoints and cost.
- IdeaTreat the draining lymph node before removing it
Shares Major pathological response (MPR), Christian Blank, Melanoma, Immune checkpoint inhibitors.
- IdeaWatch the immune system's response in the blood three weeks in
Shares RNA sequencing & expression profiling, No one can predict who responds to immunotherapy, Bladder & urothelial cancer, Melanoma.