Penpulimab-based Combination Neoadjuvant/Adjuvant Therapy for Patients With Resectable Locally Advanced Non-small Cell Lung Cancer: a Phase II Clinical Study (ALTER-L043)

Inclusion Criteria:

* Early stage IIB-IIIB (N2), operable non-small cell lung cancer, confirmed in tissue.
* Epidermal growth factor receptor/anaplastic lymphoma kinase/ROS1 gene fusions mutation was negative in primary tumor or lymph node metastasis.
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1 with no deterioration over the previous 2 weeks and a minimum life expectancy of 12 weeks.
* Lung function capacity capable of tolerating the proposed lung surgery.
* Patients had never received surgery, chemotherapy, radiotherapy or biotherapy.

Exclusion Criteria:

* Large cell carcinoma and mixed cell lung cancer.
* Any systemic anti-cancer treatment for NSCLC, including cytotoxic drug therapy, immunotherapy, experimental treatment.
* Prior treatment with local radiotherapy.
* Prior treatment with any drug that targets T cell co-stimulations pathways (such as checkpoint inhibitors).
* Prior treatment with antilotinib and other antiangiogenic drugs.
* History of hypersensitivity to any active or inactive ingredient of Penpulimab, Anlotinib or chemotherapy.
* Patients with multiple factors affecting oral medication (e.g. inability to swallow, chronic diarrhea, and intestinal obstruction, etc.).
* Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis that required steroid treatment, or any evidence of clinically active interstitial lung disease.
* Patients whose tumor has invaded important blood vessels or whose tumor is likely to invade important blood vessels and cause fatal massive hemorrhage during follow-up study.
* Patients who have had arteriovenous thrombosis events within 6 months, such as cerebrovascular accident (including transient ischemic attack), deep venous thrombosis and pulmonary embolism.
* Pregnant or lactating women.
* History of neurological or mental disorders, including epilepsy or dementia.