非小细胞肺癌NCCN指南2024V8

随着免疫检查点抑制剂这类药物临床研究数据的不断增多，不再指定具体的药物（纳武利尤单抗或帕博利珠单抗），而是用“免疫检查点抑制剂”这一类药物。

All patients should be evaluated for preoperative therapy, with strong consideration for an immune checkpoint inhibitor + chemotherapy for those patients with tumors ≥4 cm or node positive and no contraindications to immune checkpoint inhibitors.

“应评估所有患者的术前治疗，对于肿瘤≥4cm或淋巴结阳性且无免疫检查点抑制剂禁忌症的患者，强烈考虑免疫检查点抑制剂+化疗。”

Test for PD-L1 status, EGFR mutations, and ALK rearrangements (stages IB–IIIA, IIIB [T3,N2]). PD-L1 status can be incorporated with other clinical and molecular factors to determine patients who may benefit from induction chemotherapy and immune checkpoint inhibitor.

“检测PD-L1状态、EGFR突变和ALK重排（ⅠB-ⅢA、ⅢB[T3N2]期）。PD-L1状态可与其他临床和分子因素相结合，以确定哪些患者可从诱导化疗和免疫检查点抑制剂中获益。”

新辅助全身治疗：

新增了方案： Durvalumab 1500 mg and platinum-based doublet chemotherapy every 3 weeks for 4 cycles and then continued as single-agent durvalumab as adjuvant treatment after surgery (for patients with no known EGFR mutations or ALK rearrangements) (category 1); Systemic Therapy Following Surgical Resection度伐利尤单抗1500mg+铂二联化疗，q3w×4，然后继续使用单药度伐利尤单抗作为术后辅助治疗（适用于无已知的EGFR突变或ALK重排的患者）（1类）；手术切除后的全身治疗

辅助治疗：

增加了新的术后全身治疗方案：

Durvalumab 1500 mg every 4 weeks for up to 12 cycles

度伐利尤单抗1500mg，q4w，最多12个周期