Role of Surgery in Combination with Immunotherapy

Nicholas D Klemen; Mackenzie L Shindorf; Richard M Sherry

doi:10.1016/j.soc.2019.02.011

Role of Surgery in Combination with Immunotherapy

Surg Oncol Clin N Am. 2019 Jul;28(3):481-487. doi: 10.1016/j.soc.2019.02.011. Epub 2019 Apr 15.

Authors

Nicholas D Klemen¹, Mackenzie L Shindorf², Richard M Sherry³

Affiliations

¹ Department of Surgery, Yale University School of Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06511, USA.
² Surgery Branch, National Cancer Institute, National Institutes of Health, CRC Room 3-3888, 9000 Rockville Pike, Bethesda, MD 20892, USA.
³ Surgery Branch, National Cancer Institute, National Institutes of Health, CRC Room 3-5942, 9000 Rockville Pike, Bethesda, MD 20892, USA. Electronic address: sherryr@mail.nih.gov.

PMID: 31079801
DOI: 10.1016/j.soc.2019.02.011

Abstract

Improvements in systemic immunotherapy are changing the treatment of patients with advanced melanoma and many other tumors. Surgeons may be increasingly called on to manage isolated sites of immunorefractory disease or to provide palliative surgery as a bridge to systemic therapy. Here, the authors describe the biologic rationale for using surgery in patients with immunorefractory disease, provide background on the evolving role of metastasectomy for advanced melanoma, and summarize data on the use of neoadjuvant immunotherapy. Finally, the authors discuss the direction of clinical research in this rapidly evolving field.

Keywords: Checkpoint inhibitors; Immunotherapy; Metastasectomy; Metastatic melanoma; Oligometastatic; Solid tumors; Surgery.

Publication types

Review

MeSH terms

Combined Modality Therapy
Humans
Immunotherapy / methods*
Melanoma / immunology
Melanoma / pathology
Melanoma / therapy*
Metastasectomy / methods*
Neoadjuvant Therapy / methods*
Prognosis
Skin Neoplasms / immunology
Skin Neoplasms / secondary
Skin Neoplasms / therapy*