过去十年肺癌死亡率的下降可部分归因于免疫疗法的进步。免疫检查点抑制剂 (ICIs) 改变了晚期非小细胞肺癌 (NSCLC) 的治疗格局，最近在多项临床试验中进行了评估，以确认其在可切除 NSCLC 患者的新辅助、辅助和围手术期的安全性和有效性。美国食品和药物管理局 (FDA) 已批准铂类双药化疗后辅助阿替利珠单抗、新辅助纳武单抗和铂类双药化疗、铂类双药化疗后辅助派姆单抗以及用于可切除 NSCLC 的新辅助/辅助派姆单抗，并有可能即将批准额外的药物或适应症。短短几年内，新颖的数据、批准和新兴研究成果正在极大地改变公认的护理标准。尽管取得了这些进展，但这些治疗方法的最佳应用并不完全简单。本文总结了免疫治疗的生物学原理以及围手术期 ICI 的重要临床试验。我们还进一步概述了争议和未来方向，以更好地指导 NSCLC 患者的个体化治疗。版权所有 © 2024 Elsevier B.V. 保留所有权利。

The reduction in lung cancer mortality rates over the past decade can be partially ascribed to advancements in immunotherapy. Immune checkpoint inhibitors (ICIs) have transformed the therapeutic landscape for advanced non-small cell lung cancer (NSCLC) and have recently been evaluated in multiple clinical trials to confirm their safety and efficacy in the neoadjuvant, adjuvant and perioperative settings for patients with resectable NSCLC. The Food and Drug Administration (FDA) has granted approval for adjuvant atezolizumab following platinum-doublet chemotherapy, neoadjuvant nivolumab and platinum-doublet chemotherapy, adjuvant pembrolizumab after platinum-doublet chemotherapy, and neoadjuvant/adjuvant pembrolizumab for resectable NSCLC, with potential forthcoming approvals for additional agents or indications. Novel data, approvals, and emerging research findings are dramatically shifting the accepted standards of care over just a few years. Despite these advances, the optimal application of these treatments is not entirely straightforward. This article summarizes the biological rationale for immunotherapy and the important clinical trials regarding perioperative ICIs. We also further outline the controversies and future directions to better guide the individualized treatment of NSCLC patients.Copyright © 2024 Elsevier B.V. All rights reserved.