What is neoadjuvant chemotherapy?

Neoadjuvant chemotherapy means that chemo takes place before the main treatment. The goal is to improve the likelihood that the main treatment, usually surgery or radiation therapy, will be successful.

As with adjuvant chemotherapy, there are many factors involved in choosing the timing of neoadjuvant chemo.

Your doctor might recommend neoadjuvant chemotherapy in the following situations:

The primary tumor is large or pressing on vital organs, which can make surgery complicated and risky. Chemo may be able to shrink the tumor first so it’s less risky to remove.

There’s a chance that cancer cells have broken away from the primary tumor. Any complications from surgery can delay the start of adjuvant chemo. Starting with chemo can prevent tumors from developing in distant organs.

Doing chemo first can help doctors see how effective it is. That can be factored into a long-term treatment plan.

In breast cancer, shrinking the tumor before surgery may allow for breast conserving surgery over a mastectomy.

Your doctor will likely use imaging tests to monitor tumor shrinkage with neoadjuvant chemo. In some cases, there may be a pathologic complete response. This means that no cancer is found in tissue that’s removed during surgery.

Your response to neoadjuvant therapy can help guide decisions about adjuvant therapy.