Abstract: Objective  To investigate the efficacy and safety of programmed cell death protein 1 (PD-1) inhibitors combined with chemotherapy in neoadjuvant treatment for locally advanced non-small cell lung cancer (NSCLC). Methods  A retrospective analysis was conducted on clinical data of 43 patients with locally advanced (ⅡB～ⅢB) non-small cell lung cancer who received neoadjuvant immunotherapy combined with chemotherapy in the Department of Thoracic Surgery, Beijing Friendship Hospital from June 2021 to June 2023. The radiological and pathological efficacy were evaluated, meanwhile immune-related adverse events were observed. Results  The evaluation of radiological efficacy showed an objective response rate of 76.7% and a disease control rate of 93.0%. Among the 34 patients (79.1%) who underwent surgery, the R0 resection rate was 97.1%, the complete pathological response rate was 29.4%, and the major pathological response rate was 55.9%. The incidence rate of grade 1-2 immune-related adverse events was 67.4%, and the incidence rate of grade 3 or above adverse events was 7.0%. Conclusions Neoadjuvant PD-1 inhibitor combined with chemotherapy for non-small cell lung cancer has significant efficacy, with high rates of pathological response and R0 resection. The immune-related adverse events and surgical complications are within an acceptable range, indicating high safety.

Key words: PD-1 inhibitor, immunotherapy, neoadjuvant therapy, non-small cell lung cancer