虽然手术切除是可切除肺癌治疗的基石，但新辅助/辅助化疗在过去几十年中对生存率的改善有限。随着免疫检查点抑制剂 (ICIs) 在晚期 NSCLC 中的成功，人们对其在疾病早期阶段的应用越来越感兴趣。最近批准的 II-IIIA 期 NSCLC 新辅助/辅助 ICI 凸显了治疗范式的转变。在本次综述中，我们的目标是探索 PD-(L)1 抑制剂以外的替代药物的可用数据，例如针对 CTLA4 的单克隆抗体、 LAG3、TIGIT、抗血管生成药物和新辅助/围手术期治疗方案中的新疗法（抗体药物偶联物、双特异性抗体）。在分子谱和免疫表型分析的指导下，新药物和组合（有或没有 ICI 或/和化疗）在改善手术和生存结果。在早期阶段，识别预测治疗效果的生物标志物也至关重要，以便个性化新辅助/围手术期治疗策略。

While surgical resection is the cornerstone of treatment for resectable lung cancer, neoadjuvant/adjuvant chemotherapy has shown limited improvement in survival rates over the past decades. With the success of immune checkpoint inhibitors (ICIs) in advanced NSCLC, there is growing interest in their application in earlier stages of the disease. Recent approvals for neoadjuvant/adjuvant ICIs in stage II-IIIA NSCLC highlight this shift in treatment paradigms.In this review, we aim to explore available data regarding alternative agents beyond the PD-(L)1 inhibitors, such as monoclonal antibodies against CTLA4, LAG3, TIGIT, antiangiogenic drugs, and novel therapies (antibody drug conjugates, bispecific antibodies) in neoadjuvant/perioperative regimens.Novel agents and combinations (with or without ICI or/and chemotherapy), guided by molecular profiling and immune phenotyping, showed promise in improving surgical and survival outcomes. Crucial is, also in early setting, to identifying biomarkers predictive of treatment efficacy in order to personalize neoadjuvant/perioperative treatment strategies.