<p>Neoadjuvant therapy is expanding rapidly across tumor types, yet efficacy endpoints remain anchored in subjective tumor regression grading systems developed for cytotoxic therapy. We argue that post-treatment histopathology should evolve toward quantitative and biologically interpretable metrics integrating tumor burden, immune contexture, and spatial organization. We outline a validation pathway distinguishing prognostic biomarkers from true surrogate endpoints and propose a tumor- and regimen-aware framework for developing reproducible histologic endpoints in neoadjuvant oncology.</p>

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From tumor regression grading to interpretable endpoints in neoadjuvant oncology

  • Cédric Schraepen,
  • Albert Wolthuis,
  • Wentao Tang,
  • André D’Hoore,
  • Giuseppe Floris,
  • Allyson M. Peddle,
  • Xavier Sagaert,
  • Sara Verbandt,
  • Thomas McKee,
  • Inti Zlobec,
  • Jianmin Xu,
  • Sabine Tejpar,
  • Gertjan Rasschaert

摘要

Neoadjuvant therapy is expanding rapidly across tumor types, yet efficacy endpoints remain anchored in subjective tumor regression grading systems developed for cytotoxic therapy. We argue that post-treatment histopathology should evolve toward quantitative and biologically interpretable metrics integrating tumor burden, immune contexture, and spatial organization. We outline a validation pathway distinguishing prognostic biomarkers from true surrogate endpoints and propose a tumor- and regimen-aware framework for developing reproducible histologic endpoints in neoadjuvant oncology.