Can immunotherapy before lung cancer surgery help the immune system fight the tumor?

For people with early-stage lung cancer (stages IB, II, or IIIA), surgery is often the first step. But what if you could boost the body's own defenses against the cancer before the operation? This study tested exactly that. Doctors gave patients a drug called pembrolizumab—a type of immunotherapy that helps the immune system recognize and attack cancer cells—both before and after surgery. The idea was to see if this approach was practical and safe. The main thing they wanted to know was simple: after getting the drug first, could patients still go through with their planned surgery? The study enrolled 35 people to find out. The researchers also wanted to look closely at what the drug does to the immune system. They focused on special immune cells called tumor-infiltrating lymphocytes (TILs), which are like the body's soldiers that can move into a tumor. The theory was that pembrolizumab might 'unmask' these cells, helping them recognize and target the cancer. While pembrolizumab is already approved for advanced lung cancer, using it around surgery for earlier stages was new. This trial was a crucial step to see if this two-part strategy—treatment before and after an operation—is something doctors can realistically offer patients.