BREAST CANCER: Edited by Giuseppe CuriglianoIntegrating immunotherapy in the (neo)adjuvant setting of early breast cancerChan, Jack J.a,b; Tan, Tira J.Y.a,b; Dent, Rebecca A.a,bAuthor Information aDivision of Medical Oncology, National Cancer Center Singapore, Singapore bOncology Academic Clinical Program, Duke-NUS Medical School, Singapore Correspondence to Rebecca A. Dent, Division of Medical Oncology, National Cancer Center Singapore, 11 Hospital Crescent, Singapore 169610. Tel: +65 6436 8000; fax: +65 6227 2759; e-mail: [email protected] Current Opinion in Oncology: November 2020 - Volume 32 - Issue 6 - p 575-584 doi: 10.1097/CCO.0000000000000675 Buy Metrics Abstract Purpose of review Breast cancer is a relative latecomer in the success story of immuno-oncology. In this review, we focus on the preclinical and clinical lines of evidence to justify the evaluation of immune checkpoint inhibition (ICI) for the curative-intent treatment of breast cancer, the latest and ongoing trials of (neo)adjuvant immunotherapy, and practical considerations in clinical practice associated with this new treatment paradigm. Recent findings Insights from the immunobiology of breast cancer have paved the way for the new frontier of immunotherapy in this malignancy, starting from advanced stages and moving onto curable cases. Tumor-infiltrating lymphocyte quantification and PD-L1 immunohistochemistry are forerunners of predictive biomarkers for sensitivity to ICI in breast cancers. Preliminary results from phase III trials of combinatorial immunochemotherapy to treat early high-risk or locally advanced triple-negative breast cancer are encouraging for pathological complete response. Additional efficacy and patient-reported outcomes of (neo)adjuvant immunochemotherapy trials are awaited. Summary The prospect of integrating ICI in the treatment of early-stage breast cancer is promising. Questions regarding patient selection, the choice of ICI agent and combination partner in escalation strategies, sequencing and duration of treatments, cost-effectiveness and mechanisms of resistance remain to be answered by future research. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.