Does chemoselection open the door for immunotherapy?

The TISOC-1 trial addresses the important question of utilizing chemoselection with response to induction chemotherapy to stratify patients into early or late surgical resection of tumors [1]. This study raises several interesting ideas on how to tackle the challenges of treating cancer patients in an age where we are seeing an evolution of treatments available ranging from traditional chemoradiation to immunotherapy and targeted small-molecule inhibitors. Using a chemoselection approach, we have the potential to create tailored treatments for patients avoiding unnecessary toxicities. Several important questions emerge from the TISCO-1 trial, including (i) can induction chemotherapy be used to optimize current treatment options? (ii) in patients who respond to induction therapy can organ preserving surgery, avoiding radical neck dissections, be employed? and (iii) do induction chemotherapy nonresponders benefit from immunotherapy?

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