免疫检查点抑制剂 (ICIs) 的临床研究已从转移性非小细胞肺癌 (NSCLC) 的适应症扩展到早期或可切除 NSCLC 的治疗。尽管已完成的随机试验支持批准某些 ICI 作为围手术期治疗（即辅助治疗、新辅助治疗或新辅助治疗后辅助治疗），但正在进行的试验正在评估其他抗 PD-(L)1 抗体的类似适应症，或与立体定向治疗相结合身体放射治疗（SBRT）。免疫疗法的结合带来了改善可切除非小细胞肺癌患者预后的潜力，但这些进步也增加了治疗领域的复杂性，并造成了重要的知识差距。本文回顾了非小细胞肺癌局部治疗的现行标准，描述了探索 ICI 与 SBRT 联合的临床试验，并解释了最近批准的 ICI 作为围手术期治疗。接下来的讨论强调了三个重要的不确定性领域：（1）每个治疗阶段（新辅助和辅助）中给予的 ICI 对新辅助化学免疫治疗随后辅助 ICI 的总体效果的贡献； (2) 选择方案作为未来围手术期治疗随机试验的比较方案； (3) 病理完全缓解作为中间终点的作用并有助于选择辅助治疗的患者。展望未来，利益相关者将需要开展协调一致的研究工作，以解决有关可切除非小细胞肺癌最佳治疗的相关临床问题。

Clinical investigation of immune checkpoint inhibitors (ICIs) has expanded from indications in metastatic non-small cell lung cancer (NSCLC) to add to the treatment of early-stage or resectable NSCLC. Although completed randomized trials supported the approvals of some ICIs as perioperative therapies (ie, adjuvant, neoadjuvant, or neoadjuvant followed by adjuvant), ongoing trials are evaluating other anti-PD-(L)1 antibodies for similar indications, or in combination with stereotactic body radiotherapy (SBRT). The incorporation of immunotherapy brings potential to improve outcomes of patients with resectable NSCLC, but these advances have also increased the complexity of the treatment landscape and created important knowledge gaps. This article reviews the current standards for local therapies in NSCLC, describes the clinical trials exploring the combination of ICIs to SBRT, and explains the recent approvals of ICIs as perioperative therapies. A discussion follows to highlight three important areas of uncertainty: (1) the contribution of ICIs given in each treatment phase (neoadjuvant and adjuvant) to the overall effect of neoadjuvant chemoimmunotherapy followed by adjuvant ICIs; (2) the selection of regimens to serve as comparators in future randomized trials of perioperative therapies; and (3) the role of pathologic complete response as an intermediate end point and aid for selection of patients for adjuvant therapy. Moving forward, stakeholders will need to engage in concerted research efforts to address the relevant clinical questions regarding the optimal management of resectable NSCLC.