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.