Health Care Providers Say Immunotherapy Could Positively Impact Earlier-Stage Cancer


Survey participants saw potential for immunotherapy use in earlier stages of several diseases, including melanoma, lung cancer, and bladder or urothelial cancer.

A new, multinational survey of health care providers has found that the majority of participants expect immunotherapy to positively impact treatments for patients with earlier-stage cancers in the adjuvant, neoadjuvant, and peri-operative settings.

Although the respondents said they are very satisfied with current treatments in cancers for which early options are well established, they said they do not always use treatment before or after surgery. Furthermore, the vast majority of respondents said they were enthusiastic about the potential of immunotherapy in earlier-stage cancers, according to the survey.

“Cancer recurrence often marks the transition from curable to incurable disease and can be life-altering for patients, which is why we continually investigate ways to improve upon the standard of care,” said Michele Maio, MD, PhD, director of medical oncology and immunotherapy at the University Hospital of Siena, in a press release. “Optimizing cancer treatment in its early phases, before the disease returns or spreads, represents a significant opportunity and unmet need.”

According to the press release, treatment in the neoadjuvant, adjuvant, or peri-operative settings can include chemotherapy, radiation, targeted therapy, chemoradiation therapy. Immunotherapy is also a growing option in a subset of tumors, and the survey identified several trends on the current use, satisfaction, and drivers of treatment choices in early-stage cancers.

Notably, the survey found that health care providers do not always use treatment beyond surgery, with 62% saying they “sometimes” use neoadjuvant (62%), adjuvant (55%), or peri-operative (54%) treatments. The survey authors said this represents an opportunity for earlier intervention.

Similarly, survey respondents said they are more satisfied with current treatments in cancer types with well-established options for early treatment. Specifically, 60% said they are “very” or “fairly” satisfied with current neoadjuvant (67%), adjuvant (70%), and peri-operative (61%) treatment options as a whole.

However, this satisfaction varies by tumor type and is highest among cancers with well-established therapies, such as breast cancer, which had 87% satisfaction in neoadjuvant and adjuvant settings, and melanoma, which had 77% satisfaction in the adjuvant setting. Satisfaction rates were markedly lower in kidney and liver cancers, which had less than 35% satisfaction with neoadjuvant, adjuvant, and peri-operative options.

When asked about their use of immunotherapies, respondents said they use immunotherapy in earlier stages, either as approved therapies or in clinical trials, but that they do not use immunotherapy as often as other treatments. Respondents reported the most experience with chemotherapy, which likely reflects the fact that immunotherapy remains under investigation for many tumor types and was only recently approved for others.

Despite these lower rates of experience with immunotherapies, survey participants saw potential for its use in earlier stages of several diseases, including melanoma, lung cancer, and bladder or urothelial cancer. These potential benefits also align with current drivers of treatment preferences in earlier settings. The respondents said the most important potential benefits of immunotherapy are overall survival (OS) (64%), increased disease-free, event-free, or recurrence-free survival (57%), and maintenance quality of life (54%).

Finally, survey respondents said the need for more data is a major barrier to the adoption of immunotherapy in earlier stages of cancer. Specifically, 53% cited the need for more long-term data and 50% the need for OS data.

“Over the past decade, immunotherapy research has evolved, starting with a focus on metastatic cancers, and more recently, expanding to explore the role of these treatments in earlier stages of the disease,” said Jonathan Cheng, MD, senior vice president and head of oncology development at Bristol Myers Squibb, in the press release. “We hope that by addressing cancer in earlier stages, when the immune system may be more responsive and intact, immunotherapy may have the potential to prevent recurrence and ultimately lead to patients living longer.”


According to new multinational survey, health care providers believe immunotherapy has potential to positively impact earlier-stage cancer treatment landscape across tumor types. News release. Bristol Myers Squibb; September 13, 2021. Accessed September 14, 2021.

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