Corsini EM, Weissferdt A, Pataer A, et al. - Among patients with major pathological response (MPR), researchers assessed the influence of pathological nodal disease on patterns and timing of recurrence. Researchers included patients treated with neoadjuvant chemotherapy for stages I–III non-small-cell lung cancer. They histopathologically examined surgical specimens for tumor viability, categorized as ≤10% viability (MPR) or >10% (NoMPR). In this study, 58 (19%) had MPR within the primary tumor and 42 (14%) had MPRypN0 among 307 patients. After neoadjuvant chemotherapy, results indicate that MPRypN0 is the most favorable surrogate endpoint. Intensive surveillance and consideration for additional adjuvant therapy is warranted in those with ypN1-2, due to the risk of early recurrence, regardless of primary tumor MPR. The data illustrate that MPRypN0 is the most rigorous endpoint and should be recognized as a surrogate endpoint in future neoadjuvant trials. Compared to other groups in pairwise comparisons, only those with MPRypN0 had prolonged disease-free survival.