The treatment goal for patients with early-stage lung cancer is cure. Multidisciplinary discussions of surgical resectability and medical operability determine the modality of definitive local treatment (surgery or radiotherapy) and the associated systemic therapies to further improve the likelihood of cure. Trial evidence supports cisplatin-based adjuvant therapy either after surgical resection or concurrently with radiotherapy. Consensus guidelines support neoadjuvant chemotherapy in lieu of adjuvant chemotherapy and carboplatin-based regimens for patients who are ineligible for cisplatin. The incorporation of newer agents, now standard for patients with stage IV lung cancer, into the curative therapy paradigm has lagged owing to inefficient trial designs, the lengthy follow-up needed to assess survival end points and a developmental focus on the advanced-stage disease setting. Surrogate end points, such as pathological response, are being studied and might shorten trial durations. In 2018, the anti-PD-L1 antibody durvalumab was approved for patients with stage III lung cancer after concurrent chemoradiotherapy. Since then, the study of targeted therapies and immunotherapies in patients with early-stage lung cancer has rapidly expanded. In this Review, we present the current considerations in the treatment of patients with early-stage lung cancer and explore the current and future state of clinical research to develop systemic therapies for non-metastatic lung cancer.

早期肺癌患者的治疗目标是治愈。对手术可切除性和医疗可操作性的多学科讨论决定了明确的局部治疗（手术或放射治疗）的方式以及相关的全身治疗，以进一步提高治愈的可能性。试验证据支持在手术切除后或与放疗同时进行基于顺铂的辅助治疗。共识指南支持对不适合顺铂的患者采用新辅助化疗代替辅助化疗和基于卡铂的治疗方案。由于试验设计效率低下、评估生存终点所需的长期随访以及对晚期疾病的发展重点，目前 IV 期肺癌患者标准的新型药物纳入治疗范例的步伐已经滞后。环境。替代终点（例如病理反应）正在研究中，可能会缩短试验持续时间。 2018年，抗PD-L1抗体durvalumab被批准用于同步放化疗后的III期肺癌患者。此后，针对早期肺癌患者的靶向治疗和免疫治疗的研究迅速扩大。在这篇综述中，我们提出了早期肺癌患者治疗的当前考虑因素，并探讨了开发非转移性肺癌系统疗法的临床研究的当前和未来状态。