Interpretation of advances in immune therapy for non-small cell lung cancer at the 2025 European Lung Cancer Congress (ELCC)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Wen ^1,2 , LU Jiayu ¹ , ZHANG Xuxu ^1,3 , XU Xinyao ² , ZHANG Jipeng ² , LI Wei ² , LI Guizhen ² , BAO Bo ² ,  LU Qiang ²

1. Basic Medical College, Air Force Medical University, Xi'an, 710032, P. R. China;
2. Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, P. R. China;
3. Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, P. R. China;

Corresponding author：

LU Qiang, Email: luqiang@fmmu.edu.cn

Keywords：

Perioperation; non-small cell lung cancer; immune therapy; targeted therapy; interpretation

DOI：

10.7507/1007-4848.202505023

Video：

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The 2025 European Lung Cancer Congress (ELCC) convened in Paris, France, centering on the optimization and innovation of immunotherapy for non-small cell lung cancer (NSCLC). Key topics at the congress included the application strategies for perioperative immunotherapy, breakthroughs in combination therapy models for advanced NSCLC, and the emerging roles of biomarkers in predicting diverse treatment outcomes. This paper integrates data from several key pivotal studies to systematically analyze the clinical value of neoadjuvant therapy within the perioperative setting, the potential of targeted combination regimens, and the challenges of managing drug resistance, thus offering new directions for clinical practice.

1.	Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol, 2023, 20(9): 624-639.
2.	Joshi RM, Singh A, Parikh A, et al. Overview of perspectives on cancer, newer therapies, and future directions. Oncol Transl Med, 2024, 10(3): 105-109.
3.	Nuccio A, Prelaj A, Pompilio C, et al. 167P: neoadjuvant (NEO) versus perioperative (PERIOP) chemo-immunotherapy (CT-ICI) according to pathological response (PR) in resectable non-small cell lung cancer (NSCLC): an individual patient data (IPD) analysis. J Thorac Oncol, 2025, 20(3): S113-S114.
4.	Li SN, Zhang C, Zhu Y, et al. 149P: Comparative investigation of neoadjuvant chemoimmunotherapy versus perioperative (chemo) immunotherapy in resectable non-small cell lung cancer: a real-world retrospective study. J Thorac Oncol, 2025, 20(3): S106.
5.	Heymach JV, Harpole D, Mitsudomi T, et al. OA13. 03 Perioperative durvalumab for resectable NSCLC (R-NSCLC): updated outcomes from the phase 3 AEGEAN trial. J Thorac Oncol, 2024, 19(Suppl 10): S38-S39.
6.	Riely GJ, Ahn MJ, DeRuyter K, et al. Non-small cell lung cancer, version 4. 2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2024, 22(4): 249-274.
7.	Gadgeel S, Lee JS, Cho BC, et al. OA02. 03 Amivantamab plus lazertinib vs osimertinib in first-line EGFR-mutant advanced NSCLC: longer follow-up of the MARIPOSA study. J Thorac Oncol, 2024, 19(10): S10-S11.
8.	Girard N, Bar J, Audigier-Valette C, et al. Treatment characteristics and real-world progression-free survival in patients with unresectable stage Ⅲ NSCLC who received durvalumab after chemoradiotherapy: findings from the PACIFIC-R study. J Thorac Oncol, 2023, 18(2): 181-193.
9.	Zhou Q, Chen M, Jiang O, et al. Sugemalimab versus placebo after concurrent or sequential chemoradiotherapy in patients with locally advanced, unresectable, stage Ⅲ non-small-cell lung cancer in China (GEMSTONE-301): interim results of a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol, 2022, 23(2): 209-219.
10.	Peters S, Felip E, Dafni U, et al. Progression-free and overall survival for concurrent nivolumab with standard concurrent chemoradiotherapy in locally advanced stage ⅢA-B NSCLC: results from the European Thoracic Oncology Platform NICOLAS phase Ⅱ trial (European Thoracic Oncology Platform 6-14). J Thorac Oncol, 2021, 16(2): 278-288.
11.	Deng H, Liu Y, Li S, et al. Radical minimally invasive surgery after immuno-chemotherapy in initially-unresectable stage ⅢB non-small cell lung cancer. Ann Surg, 2022, 275(3): e600-e602.
12.	Wang M, Li J, Zhao X, et al. Conversion surgery for initially unresectable stage Ⅲ nonsmall cell lung cancer after induction treatment of immunochemotherapy: a multicenter study. Clin Lung Cancer, 2025, 26(3): e131-e140.
13.	Cappuzzo F, Subbiah V, Park K, et al. 233P: chemo-immunotherapy for borderline resectable and unresectable NSCLC. J Thorac Oncol, 2025, 20(3): S148.
14.	Cascone T, Provencio M, Shien K, et al. Perioperative nivolumab in resectable lung cancer. N Engl J Med, 2024, 390(19): 1756-1769.
15.	Moro-Sibilot D, Provencio M, Shien K, et al. 138P: outcomes by treatment (tx) cycles (cyc) with perioperative nivolumab (NIVO) in patients (pts) with resectable NSCLC from CheckMate 77 T study. J Thorac Oncol, 2025, 20(3): S100-S102.
16.	Westeel V, Erasmus JJ, Van Schil PEY, et al. LBA3: sites of relapse and subsequent therapy in the BR. 31 phase Ⅲ study of durvalumab vs placebo in resected stage ⅠB-ⅢA NSCLC. J Thorac Oncol, 2025, 20(3): S98-S99.
17.	Felip E, Altorki N, Zhou C, et al. Adjuvant atezolizumab after adjuvant chemotherapy in resected stage ⅠB-ⅢA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial. Lancet, 2021, 398(10308): 1344-1357.
18.	Mayenga M, Ouaknine S, Charles-Nelson A, et al. The CheckMate 816 trial: a milestone in neoadjuvant chemoimmunotherapy of nonsmall cell lung cancer. Breathe (Sheff), 2024, 20(3): 240044.
19.	Serna-Blasco R, Nadal E, Provencio M, et al. 210P: prognostic value of minimal residual disease in the NADIM Ⅱ trial. J Thorac Oncol, 2025, 20(3): S138-S139.
20.	Gandhi L, Rodríguez-Abreu D, Gadgeel S, et al. Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med, 2018, 378(22): 2078-2092.
21.	Novello S, Kowalski DM, Luft A, et al. Pembrolizumab plus chemotherapy in squamous non-small-cell lung cancer: 5-year update of the phase Ⅲ KEYNOTE-407 study. J Clin Oncol, 2023, 41(11): 1999-2006.
22.	Velcheti V, Hu X, Piperdi B, et al. 24P: 5-year real-world outcomes with first-line (1L) pembrolizumab plus (+) chemotherapy in advanced/metastatic NSCLC. J Thorac Oncol, 2025, 20(3): S26-S27.
23.	Peters S, Lim FL, Kalandadze K, et al. 17P: final analysis of PERLA, a global, randomized, phase Ⅱ double-blind trial of dostarlimab plus chemotherapy versus pembrolizumab plus chemotherapy in metastatic nonsquamous non-small cell lung cancer. J Thorac Oncol, 2025, 20(3): S21.
24.	Hou X, Zhang S, Li J, et al. 31P: camrelizumab plus chemotherapy as first-line treatment for advanced non-squamous NSCLC with brain metastases: final overall survival results from the CAP-BRAIN trial. J Thorac Oncol, 2025, 20(3): S31.
25.	Xu Y, Yang K, Zhu B, et al. Brain radiotherapy combined with camrelizumab and platinum-doublet chemotherapy for previously untreated advanced non-small-cell lung cancer with brain metastases (C-Brain): a multicentre, single-arm, phase 2 trial. Lancet Oncol, 2025, 26(1): 74-84.
26.	Oresti S, Prelaj A, Pompilio C, et al. 27P: impact of platinum-based chemotherapy (CT) on acquired resistance (AR) to first-line immunecheckpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC): individual patient data metanalysis. J Thorac Oncol, 2025, 20(3): S28-S29.
27.	Paz-Ares L, Ciuleanu TE, Cobo M, et al. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(2): 198-211.
28.	Decoster L, Aerts JGJ, Van Dam PJ, et al. 48P: real-world evaluation of ipilimumab (Ipi)/nivolumab (Nivo) in combination with two cycles of chemotherapy in patients (pts) with programmed death-ligand (PD-L1) negative advanced non-small cell lung cancer (aNSCLC): interim results of the RW-9LA study. J Thorac Oncol, 2025, 20(3): S41.
29.	Schumann CC, Brueckl WM, Scheffler M, et al. 42P: first-line (1L) nivolumab (N)+ipilimumab (I) with 2 cycles of platinum-based chemotherapy © in patients (pts) with metastatic non-small cell lung cancer (mNSCLC): interim data from the German non-interventional study (NIS) FINN. J Thorac Oncol, 2025, 20(3): S37-S38.
30.	Wang J, Lu S, Yu X, et al. 25P: durvalumab with or without tremelimumab plus chemotherapy as first-line treatment for metastatic NSCLC: results from the phase Ⅲ POSEIDON extended China cohort. J Thorac Oncol, 2025, 20(3): S27-S28.
31.	Peters S, Melillo G, Awad MM, et al. 127TiP: RELATIVITY-1093: a randomized, phase Ⅲ study of first-line nivolumab (NIVO)+relatlimab (RELA) high dose (HD) with platinum-doublet chemotherapy (PDCT) vs pembrolizumab (PEMBRO)+PDCT in patients with metastatic NSCLC having tumor PD-L1 expression≥1% and non-squamous (NSQ) histology. J Thorac Oncol, 2025, 20(3): S90-S91.
32.	Tomasini P, Lin HM, Piotrowska Z, et al. 59P: evaluating the effectiveness of amivantamab plus lazertinib in CHRYSALIS-2 vs EGFR TKI monotherapy in a matched real-world cohort of participants with atypical EGFR-mutated advanced NSCLC. J Thorac Oncol, 2025, 20(3): S47-S48.
33.	Le X, Goto Y, Su WC, et al. 1O: osimertinib (osi)+datopotamab deruxtecan (Dato-DXd) in patients (pts) with EGFR-mutated (EGFRm) advanced NSCLC (aNSCLC) whose disease progressed on first-line (1L) osi: ORCHARD. J Thorac Oncol, 2025, 20(3): S2-S4.
34.	Garassino MC, Felip E, Sakai H, et al. LBA65 KRYSTAL-7: efficacy and safety of adagrasib with pembrolizumab in patients with treatment-naïve, advanced non-small cell lung cancer (NSCLC) harboring a KRASG12C mutation. Ann Oncol, 2023, 34: S1309-S1310.
35.	Garassino MC, Johnson ML, Janne PA, et al. 5MO: first-line adagrasib (ADA) with pembrolizumab (PEMBRO) in patients (pts) with advanced/metastatic KRASG12C-mutated non-small cell lung cancer (NSCLC) and PD-L1≥50% from the phase Ⅱ portion of KRYSTAL-7. J Thorac Oncol, 2025, 20(3): S8-S10.
36.	Herbst RS, Baas P, Kim DW, et al. Long-term outcomes and retreatment among patients with previously treated, programmed death-ligand 1-positive, advanced non-small-cell lung cancer in the KEYNOTE-010 study. J Clin Oncol, 2020, 38(14): 1580-1590.

1. Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol, 2023, 20(9): 624-639.
2. Joshi RM, Singh A, Parikh A, et al. Overview of perspectives on cancer, newer therapies, and future directions. Oncol Transl Med, 2024, 10(3): 105-109.
3. Nuccio A, Prelaj A, Pompilio C, et al. 167P: neoadjuvant (NEO) versus perioperative (PERIOP) chemo-immunotherapy (CT-ICI) according to pathological response (PR) in resectable non-small cell lung cancer (NSCLC): an individual patient data (IPD) analysis. J Thorac Oncol, 2025, 20(3): S113-S114.
4. Li SN, Zhang C, Zhu Y, et al. 149P: Comparative investigation of neoadjuvant chemoimmunotherapy versus perioperative (chemo) immunotherapy in resectable non-small cell lung cancer: a real-world retrospective study. J Thorac Oncol, 2025, 20(3): S106.
5. Heymach JV, Harpole D, Mitsudomi T, et al. OA13. 03 Perioperative durvalumab for resectable NSCLC (R-NSCLC): updated outcomes from the phase 3 AEGEAN trial. J Thorac Oncol, 2024, 19(Suppl 10): S38-S39.
6. Riely GJ, Ahn MJ, DeRuyter K, et al. Non-small cell lung cancer, version 4. 2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2024, 22(4): 249-274.
7. Gadgeel S, Lee JS, Cho BC, et al. OA02. 03 Amivantamab plus lazertinib vs osimertinib in first-line EGFR-mutant advanced NSCLC: longer follow-up of the MARIPOSA study. J Thorac Oncol, 2024, 19(10): S10-S11.
8. Girard N, Bar J, Audigier-Valette C, et al. Treatment characteristics and real-world progression-free survival in patients with unresectable stage Ⅲ NSCLC who received durvalumab after chemoradiotherapy: findings from the PACIFIC-R study. J Thorac Oncol, 2023, 18(2): 181-193.
9. Zhou Q, Chen M, Jiang O, et al. Sugemalimab versus placebo after concurrent or sequential chemoradiotherapy in patients with locally advanced, unresectable, stage Ⅲ non-small-cell lung cancer in China (GEMSTONE-301): interim results of a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol, 2022, 23(2): 209-219.
10. Peters S, Felip E, Dafni U, et al. Progression-free and overall survival for concurrent nivolumab with standard concurrent chemoradiotherapy in locally advanced stage ⅢA-B NSCLC: results from the European Thoracic Oncology Platform NICOLAS phase Ⅱ trial (European Thoracic Oncology Platform 6-14). J Thorac Oncol, 2021, 16(2): 278-288.
11. Deng H, Liu Y, Li S, et al. Radical minimally invasive surgery after immuno-chemotherapy in initially-unresectable stage ⅢB non-small cell lung cancer. Ann Surg, 2022, 275(3): e600-e602.
12. Wang M, Li J, Zhao X, et al. Conversion surgery for initially unresectable stage Ⅲ nonsmall cell lung cancer after induction treatment of immunochemotherapy: a multicenter study. Clin Lung Cancer, 2025, 26(3): e131-e140.
13. Cappuzzo F, Subbiah V, Park K, et al. 233P: chemo-immunotherapy for borderline resectable and unresectable NSCLC. J Thorac Oncol, 2025, 20(3): S148.
14. Cascone T, Provencio M, Shien K, et al. Perioperative nivolumab in resectable lung cancer. N Engl J Med, 2024, 390(19): 1756-1769.
15. Moro-Sibilot D, Provencio M, Shien K, et al. 138P: outcomes by treatment (tx) cycles (cyc) with perioperative nivolumab (NIVO) in patients (pts) with resectable NSCLC from CheckMate 77 T study. J Thorac Oncol, 2025, 20(3): S100-S102.
16. Westeel V, Erasmus JJ, Van Schil PEY, et al. LBA3: sites of relapse and subsequent therapy in the BR. 31 phase Ⅲ study of durvalumab vs placebo in resected stage ⅠB-ⅢA NSCLC. J Thorac Oncol, 2025, 20(3): S98-S99.
17. Felip E, Altorki N, Zhou C, et al. Adjuvant atezolizumab after adjuvant chemotherapy in resected stage ⅠB-ⅢA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial. Lancet, 2021, 398(10308): 1344-1357.
18. Mayenga M, Ouaknine S, Charles-Nelson A, et al. The CheckMate 816 trial: a milestone in neoadjuvant chemoimmunotherapy of nonsmall cell lung cancer. Breathe (Sheff), 2024, 20(3): 240044.
19. Serna-Blasco R, Nadal E, Provencio M, et al. 210P: prognostic value of minimal residual disease in the NADIM Ⅱ trial. J Thorac Oncol, 2025, 20(3): S138-S139.
20. Gandhi L, Rodríguez-Abreu D, Gadgeel S, et al. Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med, 2018, 378(22): 2078-2092.
21. Novello S, Kowalski DM, Luft A, et al. Pembrolizumab plus chemotherapy in squamous non-small-cell lung cancer: 5-year update of the phase Ⅲ KEYNOTE-407 study. J Clin Oncol, 2023, 41(11): 1999-2006.
22. Velcheti V, Hu X, Piperdi B, et al. 24P: 5-year real-world outcomes with first-line (1L) pembrolizumab plus (+) chemotherapy in advanced/metastatic NSCLC. J Thorac Oncol, 2025, 20(3): S26-S27.
23. Peters S, Lim FL, Kalandadze K, et al. 17P: final analysis of PERLA, a global, randomized, phase Ⅱ double-blind trial of dostarlimab plus chemotherapy versus pembrolizumab plus chemotherapy in metastatic nonsquamous non-small cell lung cancer. J Thorac Oncol, 2025, 20(3): S21.
24. Hou X, Zhang S, Li J, et al. 31P: camrelizumab plus chemotherapy as first-line treatment for advanced non-squamous NSCLC with brain metastases: final overall survival results from the CAP-BRAIN trial. J Thorac Oncol, 2025, 20(3): S31.
25. Xu Y, Yang K, Zhu B, et al. Brain radiotherapy combined with camrelizumab and platinum-doublet chemotherapy for previously untreated advanced non-small-cell lung cancer with brain metastases (C-Brain): a multicentre, single-arm, phase 2 trial. Lancet Oncol, 2025, 26(1): 74-84.
26. Oresti S, Prelaj A, Pompilio C, et al. 27P: impact of platinum-based chemotherapy (CT) on acquired resistance (AR) to first-line immunecheckpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC): individual patient data metanalysis. J Thorac Oncol, 2025, 20(3): S28-S29.
27. Paz-Ares L, Ciuleanu TE, Cobo M, et al. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(2): 198-211.
28. Decoster L, Aerts JGJ, Van Dam PJ, et al. 48P: real-world evaluation of ipilimumab (Ipi)/nivolumab (Nivo) in combination with two cycles of chemotherapy in patients (pts) with programmed death-ligand (PD-L1) negative advanced non-small cell lung cancer (aNSCLC): interim results of the RW-9LA study. J Thorac Oncol, 2025, 20(3): S41.
29. Schumann CC, Brueckl WM, Scheffler M, et al. 42P: first-line (1L) nivolumab (N)+ipilimumab (I) with 2 cycles of platinum-based chemotherapy © in patients (pts) with metastatic non-small cell lung cancer (mNSCLC): interim data from the German non-interventional study (NIS) FINN. J Thorac Oncol, 2025, 20(3): S37-S38.
30. Wang J, Lu S, Yu X, et al. 25P: durvalumab with or without tremelimumab plus chemotherapy as first-line treatment for metastatic NSCLC: results from the phase Ⅲ POSEIDON extended China cohort. J Thorac Oncol, 2025, 20(3): S27-S28.
31. Peters S, Melillo G, Awad MM, et al. 127TiP: RELATIVITY-1093: a randomized, phase Ⅲ study of first-line nivolumab (NIVO)+relatlimab (RELA) high dose (HD) with platinum-doublet chemotherapy (PDCT) vs pembrolizumab (PEMBRO)+PDCT in patients with metastatic NSCLC having tumor PD-L1 expression≥1% and non-squamous (NSQ) histology. J Thorac Oncol, 2025, 20(3): S90-S91.
32. Tomasini P, Lin HM, Piotrowska Z, et al. 59P: evaluating the effectiveness of amivantamab plus lazertinib in CHRYSALIS-2 vs EGFR TKI monotherapy in a matched real-world cohort of participants with atypical EGFR-mutated advanced NSCLC. J Thorac Oncol, 2025, 20(3): S47-S48.
33. Le X, Goto Y, Su WC, et al. 1O: osimertinib (osi)+datopotamab deruxtecan (Dato-DXd) in patients (pts) with EGFR-mutated (EGFRm) advanced NSCLC (aNSCLC) whose disease progressed on first-line (1L) osi: ORCHARD. J Thorac Oncol, 2025, 20(3): S2-S4.
34. Garassino MC, Felip E, Sakai H, et al. LBA65 KRYSTAL-7: efficacy and safety of adagrasib with pembrolizumab in patients with treatment-naïve, advanced non-small cell lung cancer (NSCLC) harboring a KRASG12C mutation. Ann Oncol, 2023, 34: S1309-S1310.
35. Garassino MC, Johnson ML, Janne PA, et al. 5MO: first-line adagrasib (ADA) with pembrolizumab (PEMBRO) in patients (pts) with advanced/metastatic KRASG12C-mutated non-small cell lung cancer (NSCLC) and PD-L1≥50% from the phase Ⅱ portion of KRYSTAL-7. J Thorac Oncol, 2025, 20(3): S8-S10.
36. Herbst RS, Baas P, Kim DW, et al. Long-term outcomes and retreatment among patients with previously treated, programmed death-ligand 1-positive, advanced non-small-cell lung cancer in the KEYNOTE-010 study. J Clin Oncol, 2020, 38(14): 1580-1590.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesInterpretation of advances in immune therapy for non-small cell lung cancer at the 2025 European Lung Cancer Congress (ELCC)

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