New combo therapy shows promise for inoperable lung cancer

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Histologically proven stage I NSCLC =\< 5 cm diameter * One or more high-risk features identified: * Tumor diameter \>= 2 cm * Tumor standardized uptake value maximum (SUVmax) \>= 6.2 * Moderately, poorly differentiated or undifferentiated histology * Evaluable disease per RECIST 1.1 * Patients must be medically or surgically inoperable as determined by a physician OR unwilling to undergo surgical resection * All patients must have an forced expiratory volume in 1 second (FEV1) \>= 700cc * All patients must have a carbon monoxide diffusing capability test (DLCO) \>= 5.5 m/min/mmHg * Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2 * Life expectancy \>= 12 months * Absolute neutrophil count (ANC) \> 1500 cells/uL * White blood cell count (WBC) \> 2500/uL * Lymphocyte count \> 500/uL * Platelet count \> 100,000/uL * Hemoglobin \> 9 g/dL * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 2.5 x upper limit of normal (ULN) with alkaline phosphatase =\< 2.5 x ULN OR AST and ALT =\< 1.5 x ULN, with alkaline phosphatase \> 2.5 x ULN * Serum bilirubin =\< 1.0 x ULN * International normalized ratio (INR) and activated partial thromboplastin time (aPTT) \< 1.5 x ULN (for patients on anticoagulation they must be receiving a stable dose for at least 1 week prior to enrollment) * Creatinine clearance \> 30 mL/min by Cockcroft-Gault formula * No history of severe hypersensitivity reactions to other monoclonal antibodies (mAbs) * No other active malignancy * Patients with a history of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone are eligible * Patients with controlled type 1 diabetes mellitus on a stable insulin regimen are eligible * Archival tumor sample available; tissue from an fine-needle aspiration (FNA) is allowed but tumor tissue from a core needle biopsy is preferred * For female patients of childbearing potential and male patients with partners of childbearing potential agreement (by patient and/or partner) to use highly effective form(s) of contraception (i.e., one that results in a low failure rate \[\< 1% per year\] when used consistently and correctly) and to continue its use for 6 months after the last dose of MPDL3280A * Signed informed consent * Ability to comply with the protocol Exclusion Criteria: * Uncontrolled concomitant disease * Significant cardiovascular disease (New York Heart Association Class \[NYHA\] class II or greater); myocardial infarction within 3 month prior to randomization, unstable arrhythmias, unstable angina or a patient with a known left ventricular ejection fraction (LVEF) \< 40% * Severe infection within 4 weeks prior to enrollment * Active tuberculosis * Oral or IV antibiotics within 2 weeks or 5 half-lives prior to enrollment * History of autoimmune disease * Positive for human immunodeficiency virus (HIV), hepatitis B (hepatitis B surface antigen \[HBsAg\] reactive), or hepatitis C virus (hepatitis C virus ribonucleic acid \[HCV RNA\] \[qualitative\] is detected) * History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia * Treatment with systemic immunostimulatory agents within 4 weeks or five half-lives of the drug, whichever is shorter, prior to enrollment * Treatment with systemic corticosteroids or other systemic immunosuppressive medications within past 4 weeks or 5 half-lives whichever is shorter * Pregnant and/or lactating women