The Evolving Role of Neoadjuvant Immunotherapy and the Biomarkers Available in Decision-Making

The application of immunotherapy has profoundly changed the field of oncology, with immune checkpoint inhibitors and related agents now recognized as a mainstay for multiple cancer types. Beyond their established roles in advanced and adjuvant settings, immunotherapies are rapidly entering the neoadjuvant arena, offering the potential to downstage tumors, stimulate systemic immune responses, and improve rates of curative resection. Early-phase clinical trials across solid tumors such as non-small cell lung cancer, melanoma, breast, bladder, and gastrointestinal cancers report encouraging rates of pathological complete response, an outcome linked to enhanced long-term survival. However, questions remain regarding inter-patient variability in response, the management of immune-related adverse events before surgery, and the best strategies for integrating immunotherapy with existing neoadjuvant modalities.

This Research Topic aims to collate, interrogate, and expand evidence concerning the clinical deployment of neoadjuvant immunotherapy in solid tumors. Key objectives include synthesizing trial-based knowledge on efficacy, safety, pathological response, and survival outcomes for neoadjuvant immunotherapy, while critically evaluating both established and novel biomarkers for their ability to predict and monitor response. The topic will also explore the complex interactions between tumor biology, immune microenvironment, and therapeutic outcomes, assess the operational impact of neoadjuvant immunotherapy on surgical planning and perioperative care, and spotlight emerging liquid biopsy and multi-omic platforms. Ultimately, the goal is to catalyze development of evidence-based, biomarker-driven clinical frameworks for patient selection, sequencing, and monitoring in the neoadjuvant immuno-oncology space.

This Research Topic covers the translation of immunotherapy into the neoadjuvant setting for adult solid malignancies, focusing on predictive and prognostic biomarkers, therapeutic combinations, perioperative management, and clinical implementation. Research is limited to studies involving immunotherapy administered prior to definitive surgery or ablation and related translational science.

To gather further insights within these boundaries, we welcome articles addressing, but not limited to, the following themes:

- Clinical trials and real-world data on neoadjuvant immunotherapy efficacy, safety, and survival outcomes in diverse solid tumors.

- Assessment and validation of predictive and prognostic biomarkers, including PD-L1, TMB, dMMR, TILs, and multi-omic approaches.

- Liquid biopsy-based tools (ctDNA, CTCs, methylation) for response evaluation and dynamic therapeutic adaptation.

- Characterization of the tumor immune microenvironment and mechanisms of resistance to neoadjuvant immunotherapy.

- Optimal strategies for combining neoadjuvant immunotherapy with chemotherapy, radiotherapy, or targeted therapies.

- Impacts of neoadjuvant immunotherapy on surgical complexity, perioperative care, and postoperative outcomes.

- Disease- and organ-specific perspectives, including NSCLC, melanoma, breast, urologic, gastrointestinal, and rare tumors.





Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases that are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of the scope of this Research Topic.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Systematic Review
• Technology and Code

Keywords: neoadjuvant immunotherapy, immune checkpoint inhibitors, biomarkers

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.