NeoAdjuvant & Adjuvant Therapy: Questions Getting Answered

Sapna Patel, MD
Chair SWOG Melanoma Committee, University of Colorado
Dr. William Robinson Endowed Chair, Professor in Cancer Research
One of the leading experts in this field is Dr. Sapna Patel, MD, who currently serves as the Chair of SWOG Melanoma Committee at the University of Colorado. She holds the prestigious William Robinson Endowed Chair and is also a Professor in Cancer Research.
Patients diagnosed with high-risk Stage III melanoma could gain advantages from a neoadjuvant approach, where treatment is administered prior to surgical interventions. The objectives of neoadjuvant therapy are to amplify the immune system's response against the tumor and to reduce the size of the tumor. This can lead to a better outcome for the patient, with improved survival rates and potential for long-term remission.
Adjuvant therapy serves as a supplementary treatment administered following the initial treatment of a disease. In the context of melanoma, it is often employed post-surgery to minimize the likelihood of the disease's recurrence. Patients who have undergone surgical procedures for melanoma and are considered at elevated risk for its return may benefit from this approach.
Neoadjuvant therapy is given before surgery and adjuvant therapy is given after surgery. This difference in timing can have a significant impact on the efficacy of the treatment.
Neoadjuvant therapy allows for treatment to be administered while the tumor is still present, which can help to shrink it and make surgical removal easier. It also enables doctors to assess how well a patient responds to a particular treatment, providing valuable information for future treatments.
On the other hand, adjuvant therapy works by targeting any remaining cancer cells after surgery, reducing the risk of recurrence. It may also have a preventative effect by strengthening the immune system against potential future tumors.
While both approaches have their benefits, they also come with their own set of side effects and risks. Neoadjuvant therapy can cause damage to healthy cells, leading to temporary or permanent organ dysfunction. Adjuvant therapy may also have long-term effects on the body, such as increased risk of secondary cancers.
Ultimately, the decision between neoadjuvant and adjuvant therapy depends on a variety of factors, including the type and stage of cancer, overall health of the patient, and potential side effects. It is important for patients to work closely with their medical team to determine the best course of treatment for their specific case.
In addition to traditional chemotherapy drugs, there are also targeted therapies available that specifically target cancer cells while minimizing damage to healthy cells. These treatments are often used in combination with neoadjuvant or adjuvant therapy, providing a more personalized approach to cancer treatment.
It is important for patients to understand that neoadjuvant and adjuvant therapies are not always necessary or beneficial for every type of cancer. In some cases, surgery alone may be enough to effectively treat the cancer, while in others, these additional treatments can greatly improve the chances of a successful outcome.
Neoadjuvant and adjuvant therapies play important roles in cancer treatment by helping to shrink tumors prior to surgery and prevent recurrence after surgery. While they may have their own unique benefits and risks, it is ultimately up to the patient and their medical team to determine the best course of action for their specific case. By staying informed and working closely with their doctors, patients can make the most informed decisions about their cancer treatment.