仅有少数肺癌在诊断时能够进行手术切除，而且其中许多病例最终都会复发。辅助化疗在这种情况下具有适度的生存优势，因此迫切需要新的方法来提高治愈率。检查点抑制剂免疫疗法已经彻底改变了晚期肺癌的预后，并且在新辅助治疗中越来越常用，单独使用或与细胞毒性化疗联合使用。虽然这种疗法在事件无进展生存和病理反应方面取得了令人信服的改善，但是关于治疗的最佳持续时间、预测和预后生物标志物、疗效评估以及与其他治疗方式的联合使用还存在着问题。此外，这些结果必须考虑在最近有关辅助免疫疗法的积极研究的背景下。本文总结了这一领域的临床前背景和临床试验，讨论了争议和问题，并考虑了未来的挑战。版权所有 © 2023 Elsevier B.V.出版。

Only a minority of lung cancers are resectable at diagnosis, and many of these will eventually relapse. Adjuvant chemotherapy in this setting has a modest survival advantage, and there is significant need for new approaches to improve cure rates. Checkpoint inhibitor immunotherapy has transformed the prognosis for advanced lung cancer, and is increasingly being used in the neoadjuvant setting alone, or in combination with cytotoxic chemotherapy. While this has demonstrated convincing improvements in event-free survival and pathologic response, questions remain over optimal duration of therapy, predictive and prognostic biomarkers, response assessment and combination with other modalities. In addition, these results must be considered in the context of recent positive studies of adjuvant immunotherapy. Here, we summarise preclinical context and clinical trials in this space, discuss areas of controversy and pitfalls, and consider future challenges.Copyright © 2023. Published by Elsevier B.V.