在过去的十年里，分别针对基因驱动非小细胞肺癌的靶向治疗和非基因驱动的免疫检查点抑制剂，大大提高了对于不可切除非小细胞肺癌患者的生存率和生活质量。越来越多的这些基于生物标志物的系统性治疗在早期非小细胞肺癌患者的手术前或手术后得到应用。2022年3月，美国FDA批准了中和前奈伐珠单抗和化疗联合应用于Ib-IIIA期非小细胞肺癌患者的治疗。数个II/III期试验正在评估不同中和前免疫检查点抑制剂联合治疗非基因驱动非小细胞肺癌和靶向治疗基因驱动非小细胞肺癌的临床有效性。然而，精准中和前治疗的临床应用需要在早期非小细胞肺癌的诊断过程中进行生物标志物测试和多学科协作的范式转变。在这篇综述中，我们总结了当前的诊断和治疗情况，最新的进展，生物标志物测试和终点选择的新挑战，及诊断过程中及时的多学科合作的实际考虑，以及对于可切除早期非小细胞肺癌患者新兴中和前精准系统治疗的展望。这些基于生物标志物的中和前治疗承诺可以改善手术和病理结果，减少全身复发，指导术后治疗，并提高可切除非小细胞肺癌患者的治愈率。© 2022。这是一份美国政府工作，不受版权保护;可能适用外国版权保护。

Over the past decade, targeted therapy for oncogene-driven NSCLC and immune checkpoint inhibitors for non-oncogene-driven NSCLC, respectively, have greatly improved the survival and quality of life for patients with unresectable NSCLC. Increasingly, these biomarker-guided systemic therapies given before or after surgery have been used in patients with early-stage NSCLC. In March 2022, the US FDA granted the approval of neoadjuvant nivolumab and chemotherapy for patients with stage IB-IIIA NSCLC. Several phase II/III trials are evaluating the clinical efficacy of various neoadjuvant immune checkpoint inhibitor combinations for non-oncogene-driven NSCLC and neoadjuvant molecular targeted therapies for oncogene-driven NSCLC, respectively. However, clinical application of precision neoadjuvant treatment requires a paradigm shift in the biomarker testing and multidisciplinary collaboration at the diagnosis of early-stage NSCLC. In this comprehensive review, we summarize the current diagnosis and treatment landscape, recent advances, new challenges in biomarker testing and endpoint selections, practical considerations for a timely multidisciplinary collaboration at diagnosis, and perspectives in emerging neoadjuvant precision systemic therapy for patients with resectable, early-stage NSCLC. These biomarker-guided neoadjuvant therapies hold the promise to improve surgical and pathological outcomes, reduce systemic recurrences, guide postoperative therapy, and improve cure rates in patients with resectable NSCLC.© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.