title: Neoadjuvant Model in Cancer Treatment: From Clinical Opportunity to Health-Care Utility.
abstract: In the last few decades, research has demonstrated that cancer can be treated and cured if diagnosed at very early stage and a proper therapeutic strategy is adopted. Recent omics-based approaches have unveiled the molecular mechanisms of cancer tumorigenesis and have aided in identifying next-generation molecular markers for early diagnosis, prognosis, and targeted therapy. New tests based on genomic profiling, circulating tumor cells, or mutation profiling are appraised for purpose by Health Technology Assessment. The potential clinical utility of these tests lies on their ability to discriminate between patients who will benefit to a greater or lesser extent from a therapeutic intervention. Assessment of new technologies for the management of cancer could be of interest to other countries given the potentially high impact that they can have on the quality and cost of health care services.
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT). d.generali@ospedale.cremona.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Fox
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofanilli
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bianchini
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Alberto
authors.initials: A
authors.lastname: Zambelli
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Christos
authors.initials: C
authors.lastname: Hatzis
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Massimo
authors.initials: M
authors.lastname: Barberis
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Rosanna
authors.initials: R
authors.lastname: Tarricone
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Alberto
authors.initials: A
authors.lastname: Bottini
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Camillo
authors.initials: C
authors.lastname: Rossi
authors.affiliation: U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT).
authors.forename: Michele
authors.initials: M
authors.lastname: Tringali
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D023281:Genomics / Q000379:methods / Q000639:trends; D006801:Humans; D020360:Neoadjuvant Therapy / Q000191:economics / Q000379:methods* / Q000639:trends; D009369:Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D009360:Neoplastic Cells, Circulating / Q000378:metabolism; D010342:Patient Acceptance of Health Care
chemical_list: D014408:Biomarkers, Tumor