Immunologic and biologic properties of the primary tumor during prolonged neoadjuvant chemoimmunotherapy.

Patients with locally advanced cancers have a poor prognosis when treated with radiotherapy and/or surgery alone. The appearance of distant metastases shortly after removal of the primary tumor indicates that micrometastases are already present at the time of diagnosis. We observed a favorable outcome in patients with locally advanced breast cancer treated with a prolonged regimen of neoadjuvant chemotherapy plus granulocyte-macrophage colony-stimulating factor (GM-CSF[Leukine]) compared with patients receiving fewer chemotherapy cycles prior to surgery and radiotherapy.