Phase 3 IMpower030 data added a new benchmark for early-stage lung cancer immunotherapy, reporting that perioperative atezolizumab plus chemotherapy more than doubled event-free survival versus chemotherapy alone in resectable stage II to IIIB non-small cell lung cancer. The result strengthens the case for earlier checkpoint inhibitor use in curable disease. In parallel, a translational modeling study in the British Journal of Cancer challenged a core pharmacology assumption behind pembrolizumab dosing: receptor occupancy at PD-1 was reported to fail to predict immune activation. The finding targets the gap between biomarker theory and the biology seen in patients. Elsewhere in lung oncology, an antibody–drug combination with sacituzumab govitecan plus pembrolizumab fell short in a Phase 3 trial for PD-L1-high metastatic lung cancer, failing to improve progression-free survival. Together, the three stories highlight both efficacy signals and mechanistic limits as companies refine immunotherapy strategies.