Progress in perioperative immunotherapy for lung cancer and analysis of therapy (Review)

Surgical treatment has long been the preferred approach for lung cancer. In recent years, postoperative adjuvant immunotherapy following surgical treatment has demonstrated good efficacy. Building on this foundation, the introduction of neoadjuvant immunotherapy prior to surgery has also reported promising results in a number of clinical trials. The aim of the present review was to summarize recent research findings associated with perioperative immunotherapy for lung cancer, including key outcomes from both neoadjuvant and adjuvant therapies. The discussion of the results of the present review primarily addressed efficacy, safety, survival data and programmed death-ligand 1 subgroup analyses. Furthermore, the advantages and limitations of different treatment modalities, including monotherapies and combination therapies, were discussed. Furthermore, the present review incorporated discussions on the applicability of biomarkers in perioperative immunotherapy, the role of immunotherapy combined with other treatments during the perioperative period, mechanisms of resistance and potential solutions to these challenges. In conclusion, the present review offers a systematic examination of the theoretical foundations of perioperative immunotherapy for lung cancer, simultaneously presenting key clinical evidence (including neoadjuvant therapy, adjuvant therapy and 'sandwich' combination regimens), diverse combination strategies (chemotherapy and radiotherapy), the current status of biomarker applications and challenges in underlying drug resistance mechanisms for perioperative immunotherapy. It proposes a dynamic monitoring model and clinical decision pathway for omission of adjuvant immunotherapy in non-small cell lung cancer. Lastly, based upon the latest evidence-based medical research, the present review aims to provide clinicians and researchers with comprehensive decision-making references and scientific guidance.