Opportunities and challenges of immunotherapy for patients with resectable and potentially resectable stage III non-small cell lung cancer

The integration of immune checkpoint inhibitors has transformed the therapeutic landscape for patients with resectable and potentially resectable stage III non-small cell lung cancer, providing unprecedented opportunities for curative treatment. Several trials have investigated immune checkpoint inhibitors, either alone or in combination with chemotherapy or radiotherapy, as neoadjuvant and/or adjuvant approaches for resectable and potentially resectable stage III non-small cell lung cancer. This comprehensive review elaborates and deeply analyzes the evolving evidence from landmark clinical trials and emerging treatment strategies. Despite these promising outcomes, significant challenges remain, including optimal treatment modality selection, controversy about adjuvant immunotherapy for patients who have already achieved a pathologic complete response, appropriate endpoint evaluation, and biomarker identification. This review also discusses future directions for optimizing immunotherapy integration in patients with resectable stage III non-small cell lung cancer, emphasizing the need for personalized treatment approaches to maximize patient benefit while addressing unanswered clinical questions.