在2025年欧洲肺癌大会（ELCC）上，国际肺癌研究协会（IASLC）候任主席、上海市东方医院肿瘤科周彩存教授与2025 ELCC联合主席、意大利都灵大学胸外科Enrico Ruffini教授展开深度对话，讨论了新辅助化疗联合免疫治疗与微创手术的整合、围手术期免疫治疗患者选择、辅助治疗时长优化、降阶梯策略等议题，揭示了多学科协作下的治疗新范式。
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肿瘤瞭望：新辅助化疗联合免疫治疗、辅助免疫治疗和围手术期免疫治疗在可切除NSCLC患者中均积累了循证证据。哪些NSCLC患者更能从围手术期免疫治疗中获益？
周教授：目前已有足够数据支持围手术期免疫治疗（新辅助化疗联合免疫治疗+辅助免疫治疗）在早期可切除NSCLC患者中的应用。综合多项试验数据，III期或II期患者可能从围手术免疫治疗中获益更多，病理完全缓解（pCR）率约为25%，这一数值在新辅助化疗中并不常见。我认为III期或II期NSCLC患者更应接受围手术期治疗，该疗法的安全性尚可接受，大部分患者的不良事件为1级或2级，且可通过常规手段管理。
Dr.Zhou:Nowadays，we have enough data to support neoadjuvant chemo-IO and adjuvant IO in early stage resectable non-small cell lung cancer.When we look at all the data across trials，maybe stage 3 or stage 2 can get much more benefit from this therapy.The pCR rate is around 25%，which is not bad and seldom seen with neoadjuvant chemotherapy.I do think stage 3 or stage 2 get more benefit from perioperative neoadjuvant chemo-IO therapy.The safety profile of this therapy is acceptable.The majority of patients experience grade 1 or grade 2 adverse events.The majority of events are manageable with common practices.I support neoadjuvant plus adjuvant chemo-IO in the early stage NSCLC.
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