Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy

Abstract Non-small cell lung cancer (NSCLC) continues to be a leading cause of cancer-related deaths globally, primarily due to its late diagnosis and the complex nature of its tumor microenvironment (TME). Within this environment, cancer-associated fibroblasts (CAFs) play a crucial role in regulati...

Full description

Saved in:
Bibliographic Details
Main Authors: Ziheng Wu, Meilin Luo, Huiyi Hu, Zhijun Jiang, Yinan Lu, Zhi-Jie Xiao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Translational Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12967-025-06791-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849332036024664064
author Ziheng Wu
Meilin Luo
Huiyi Hu
Zhijun Jiang
Yinan Lu
Zhi-Jie Xiao
author_facet Ziheng Wu
Meilin Luo
Huiyi Hu
Zhijun Jiang
Yinan Lu
Zhi-Jie Xiao
author_sort Ziheng Wu
collection DOAJ
description Abstract Non-small cell lung cancer (NSCLC) continues to be a leading cause of cancer-related deaths globally, primarily due to its late diagnosis and the complex nature of its tumor microenvironment (TME). Within this environment, cancer-associated fibroblasts (CAFs) play a crucial role in regulating NSCLC progression and therapeutic resistance. Recent advancements in single-cell and spatial technologies have uncovered significant heterogeneity among CAFs, revealing distinct subpopulations with varying cellular origins, phenotypes, and functions. Besides, the role of small extracellular vesicles (sEVs) in facilitating bidirectional communication highlights functional importance of CAF derived sEVs in mediating the crosstalk between cancer and TME, implicating the potential of CAF-sEVs to be un-invasive diagnostic biomarkers for NSCLC. Despite such new insights, challenges remain exist, particularly concerning the mechanisms that drive CAF plasticity, the interactions between specific CAF subsets with cancer cells or immune cells, and the translational significance of CAF-sEVs. In this review, we summarize the latest advances in our understanding of CAF heterogeneity, the functional roles and clinical relevance of CAFs and their secreted sEVs in driving NSCLC, and the translational landscape of CAF-targeted strategies. By critically evaluating the most recent evidence, this review provides clinically relevant insights and highlights future directions for overcoming CAF-mediated barriers to therapy. Our aim is to facilitate the development of more precise, biomarker-driven, and safe approaches for targeting CAFs, ultimately improving personalized treatment and outcomes for patients with NSCLC.
format Article
id doaj-art-5f0d7e96c84b4d5998053b6512d2f4bb
institution Kabale University
issn 1479-5876
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series Journal of Translational Medicine
spelling doaj-art-5f0d7e96c84b4d5998053b6512d2f4bb2025-08-20T03:46:20ZengBMCJournal of Translational Medicine1479-58762025-07-0123112010.1186/s12967-025-06791-xHidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapyZiheng Wu0Meilin Luo1Huiyi Hu2Zhijun Jiang3Yinan Lu4Zhi-Jie Xiao5Scientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen UniversitySouthern Medical UniversityScientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen UniversityScientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen UniversityScientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen UniversityScientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen UniversityAbstract Non-small cell lung cancer (NSCLC) continues to be a leading cause of cancer-related deaths globally, primarily due to its late diagnosis and the complex nature of its tumor microenvironment (TME). Within this environment, cancer-associated fibroblasts (CAFs) play a crucial role in regulating NSCLC progression and therapeutic resistance. Recent advancements in single-cell and spatial technologies have uncovered significant heterogeneity among CAFs, revealing distinct subpopulations with varying cellular origins, phenotypes, and functions. Besides, the role of small extracellular vesicles (sEVs) in facilitating bidirectional communication highlights functional importance of CAF derived sEVs in mediating the crosstalk between cancer and TME, implicating the potential of CAF-sEVs to be un-invasive diagnostic biomarkers for NSCLC. Despite such new insights, challenges remain exist, particularly concerning the mechanisms that drive CAF plasticity, the interactions between specific CAF subsets with cancer cells or immune cells, and the translational significance of CAF-sEVs. In this review, we summarize the latest advances in our understanding of CAF heterogeneity, the functional roles and clinical relevance of CAFs and their secreted sEVs in driving NSCLC, and the translational landscape of CAF-targeted strategies. By critically evaluating the most recent evidence, this review provides clinically relevant insights and highlights future directions for overcoming CAF-mediated barriers to therapy. Our aim is to facilitate the development of more precise, biomarker-driven, and safe approaches for targeting CAFs, ultimately improving personalized treatment and outcomes for patients with NSCLC.https://doi.org/10.1186/s12967-025-06791-xNon-small cell lung cancerCancer associated fibroblastHeterogeneityImmune suppressionExtracellular vesiclesDrug resistance
spellingShingle Ziheng Wu
Meilin Luo
Huiyi Hu
Zhijun Jiang
Yinan Lu
Zhi-Jie Xiao
Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
Journal of Translational Medicine
Non-small cell lung cancer
Cancer associated fibroblast
Heterogeneity
Immune suppression
Extracellular vesicles
Drug resistance
title Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
title_full Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
title_fullStr Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
title_full_unstemmed Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
title_short Hidden forces: the impact of cancer-associated fibroblasts on non-small cell lung cancer development and therapy
title_sort hidden forces the impact of cancer associated fibroblasts on non small cell lung cancer development and therapy
topic Non-small cell lung cancer
Cancer associated fibroblast
Heterogeneity
Immune suppression
Extracellular vesicles
Drug resistance
url https://doi.org/10.1186/s12967-025-06791-x
work_keys_str_mv AT zihengwu hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy
AT meilinluo hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy
AT huiyihu hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy
AT zhijunjiang hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy
AT yinanlu hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy
AT zhijiexiao hiddenforcestheimpactofcancerassociatedfibroblastsonnonsmallcelllungcancerdevelopmentandtherapy