[Progress of immune checkpoint inhibitors in neoadjuvant therapy of non-small cell lung cancer].

Lung cancer carries the highest morbidity and mortality out of all malignancies in the world. About 85% of all cases are non-small cell lung cancer (NSCLC). Surgery is currently the optimal treatment for early-stage NSCLC, however, the postoperative recurrence rate is relatively high and the long-term survival of these patients is still a problem to be overcomed. Previous studies have shown that early-stage NSCLC patients may benefit from preoperative neoadjuvant chemotherapy when compared to surgery alone, although the benefit is only moderate. More recent publications indicate that immune checkpoint blockade may have better potential in neoadjuvant therapy, with reported major pathological response rates at 20% to 85%, compared to chemotherapy alone. Phase Ⅲ random clinical trials are being implemented to confirm the effect of neoadjuvant immunotherapy in NSCLC. Meanwhile, a number of questions remain unanswered, including the time and course of neoadjuvant immunotherapy, the evaluation criteria of immune-related efficacy, the standardization of pathological evaluation, and how to avoid delays in surgery or misjudgment caused by pseudo-progression.早期非小细胞肺癌的治疗以手术为主，但术后复发率较高，患者如何获得长期生存仍然是亟待攻克的难题。既往研究结果显示，术前新辅助化疗较单纯手术可使患者有更好的生存获益，但获益程度尚不令人满意。近期研究结果显示，将免疫治疗用于新辅助治疗极具潜力，可使20%~85%的病例获得主要病理学缓解，优于既往新辅助化疗研究的数据。更多的三期随机对照研究正在进行，试图证实这一疗法在非小细胞肺癌治疗中的作用。与此同时，目前仍有诸多问题尚待回答，如新辅助免疫治疗的时间与疗程、免疫相关疗效评估标准、病理学评估的标准化、规避因假性进展导致的治疗延迟或决策错误的方法等。.