’Correspondence - A Commentary on ‘Comparative Investigation of Neoadjuvant Immunotherapy Versus Adjuvant Immunotherapy in Perioperative Patients with Cancer’ - Editor

Sep 21, 2026

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Letter to the editor commenting on a global-scale, cross-sectional, large-sample informatics study comparing neoadjuvant versus adjuvant immunotherapy in perioperative cancer patients. The commentary highlights the post-2020 shift toward neoadjuvant focus and the study’s value in identifying underexplored directions. It also critiques reliance on bibliometric methods, limited direct prognostic comparison, non-discriminated immunotherapy modalities, and potential database bias. The letter calls for head-to-head prospective phase III trials with longer follow-up and deeper subgroup, biomarker, and predictive-model analyses.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Key background and study significance

Mechanistic comparison of neoadjuvant vs adjuvant approaches

Limitations of the current informatics/bibliometric design

Recommendations for future research and trial design

’Correspondence A commentary on ‘Comparative investigation of neoadjuvant immunotherapy versus adjuvant immunotherapy in perioperative patients with cancer: a global-scale, cross-sectional, largesample informatics study’ Jia Yang, MD, Zhongqi Wang, MD, Haibin Deng, PhD* Dear Editor, The ﬁeld of immunotherapy has signiﬁcantly revolutionized cancer treatment, providing new avenues for enhancing patient outcomes during the perioperative period. Perioperative immunotherapy has also emerged as a new hotspot in clinical research[1] . The recent study by Guo et al. [2], published in the International Journal of Surgery, offers a comprehensive global, cross-sectional, large-sample informatics analysis that compares neoadjuvant immunotherapy with adjuvant immunotherapy inpatients with perioperative cancer. This study is particularly timely, as their results showed that the global focus of immunotherapy shifted from adjuvant therapy to neoadjuvant therapy following 2020, with the efﬁcacy and safety of neoadjuvant immunotherapy becoming a burgeoning area. Notably, the research predicts key yet underexplored research directions, such as non-small cell lung cancer, immune checkpoint inhibitors, pathological complete response, interleukin-2, melanoma, and dendritic cells. This foresight could guide future research to ﬁll existing gaps in our understanding of cancer immunotherapy. Neoadjuvant and adjuvant immunotherapies have succeeded remarkably in clinical practice, outperforming traditional chemotherapy. Neoadjuvant immunotherapy, administered before surgical intervention, leverages intact tumor antigens and a lymphatic tumor microenvironment to enhance immune efﬁcacy, manage micrometastases, and reduce recurrence risks. In contrast, postoperative adjuvant immunotherapy blocks immune checkpoint expression, such as PD-1/ CTLA-4, thus restoring T cell anti-tumor activity and facilitating the capture and killing of cancer cells[3] . However, Department of Oncology, Longhua Hospital afﬁliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People ’s Republic of China Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article. *Corresponding author. Address: Department of Oncology, Longhua Hospital afﬁliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, People’s Republic of China. Tel.: +[86 136 615 782 00. E-mail: haibindengzr@163.com](86 136 615 782 00. E-mail: haibindengzr@163.com) (H. Deng). Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. International Journal of Surgery (2024) 110:6007–6008 Received 16 May 2024; Accepted 19 May 2024 Published online 29 May 2024 [http://dx.doi.org/10.1097/JS9.0000000000001712](http://dx.doi.org/10.1097/JS9.0000000000001712) research exploring the differences in the mechanisms and therapeutic effects between the two therapies remains scarce, underlining an urgent need for enhanced treatment strategies to improve patient prognoses. Guo et al. employed unsupervised hierarchical clustering, time-series analysis, the Walktrap algorithm, and other informatic methods to provide a macroscopic perspective of the current landscape of cancer immunotherapy, highlighting potential future research directions. Despite these advanced methods, the study primarily relies on bibliometric analysis based on literature data, lacking a direct comparison or validation of the exact differences in patient prognosis and clinical efﬁcacy between neoadjuvant and adjuvant immunotherapy. This limitation underscores the necessity for headto-head prospective phase III clinical trials [4] . Second, althoug

FAQs

What study does the correspondence primarily comment on?

It comments on a global-scale, cross-sectional, large-sample informatics study by Guo et al. that compares neoadjuvant immunotherapy with adjuvant immunotherapy in perioperative cancer patients.

What shift in immunotherapy focus is described after 2020?

The correspondence states that the global focus shifted from adjuvant therapy to neoadjuvant therapy, with neoadjuvant efficacy and safety becoming an emerging area.

What are the main limitations emphasized about the study design?

The letter notes that the work relies mainly on bibliometric analysis from literature data, lacks direct head-to-head prognostic validation, does not differentiate immunotherapy modalities in the inclusion criteria, and may have bias from relying on a specific database.

Sep 21, 2026

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