Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy

Lung cancer, predominantly non-small cell lung cancer (NSCLC), remains a principal driver of cancer-related morbidity and mortality worldwide. Despite advancements in surgery, radiotherapy, chemotherapy, and targeted treatments, outcomes remain poor in advanced NSCLC. The tumor microenvironment (TME...

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Main Authors: Haiyi Xue, Yilan Fan, Yi Li, Qian Zhao, Xuelu Zhang, Pei Zhao, Zhenjun Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1610998/full
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author Haiyi Xue
Yilan Fan
Yi Li
Qian Zhao
Xuelu Zhang
Pei Zhao
Zhenjun Liu
author_facet Haiyi Xue
Yilan Fan
Yi Li
Qian Zhao
Xuelu Zhang
Pei Zhao
Zhenjun Liu
author_sort Haiyi Xue
collection DOAJ
description Lung cancer, predominantly non-small cell lung cancer (NSCLC), remains a principal driver of cancer-related morbidity and mortality worldwide. Despite advancements in surgery, radiotherapy, chemotherapy, and targeted treatments, outcomes remain poor in advanced NSCLC. The tumor microenvironment (TME) exerts a critical influence on therapy responses. Within the TME, immune cells such as T and B lymphocytes, dendritic cells, myeloid-derived suppressor cells, tumor-associated macrophages, neutrophils, and natural killer cells can drive both pro- and anti-tumor processes. This review integrates their classification, phenotypic plasticity, and roles in NSCLC, highlighting key preclinical and clinical evidence while discussing pathogenesis, prognostic significance, and therapeutic potential. We also summarize the current immunotherapeutic strategies for advanced NSCLC, including first- or second-line regimens with immune checkpoint inhibitors alone or combined with chemotherapy, anti-angiogenic agents, or additional checkpoint inhibitors, and future directions. By elucidating the interplay between the NSCLC immune microenvironment and emerging immunotherapies, this review emphasizes the need for novel combination regimens and robust predictive biomarkers to improve clinical outcomes and extend survival in advanced NSCLC.
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series Frontiers in Immunology
spelling doaj-art-7ceff81b8c87470dbebadbfa01deee682025-08-20T03:32:23ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16109981610998Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapyHaiyi Xue0Yilan Fan1Yi Li2Qian Zhao3Xuelu Zhang4Pei Zhao5Zhenjun Liu6Department of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of General Medicine, MianYang Cancer Hospital, Mianyang, ChinaDepartment of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Intensive Care Unit, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, ChinaLung cancer, predominantly non-small cell lung cancer (NSCLC), remains a principal driver of cancer-related morbidity and mortality worldwide. Despite advancements in surgery, radiotherapy, chemotherapy, and targeted treatments, outcomes remain poor in advanced NSCLC. The tumor microenvironment (TME) exerts a critical influence on therapy responses. Within the TME, immune cells such as T and B lymphocytes, dendritic cells, myeloid-derived suppressor cells, tumor-associated macrophages, neutrophils, and natural killer cells can drive both pro- and anti-tumor processes. This review integrates their classification, phenotypic plasticity, and roles in NSCLC, highlighting key preclinical and clinical evidence while discussing pathogenesis, prognostic significance, and therapeutic potential. We also summarize the current immunotherapeutic strategies for advanced NSCLC, including first- or second-line regimens with immune checkpoint inhibitors alone or combined with chemotherapy, anti-angiogenic agents, or additional checkpoint inhibitors, and future directions. By elucidating the interplay between the NSCLC immune microenvironment and emerging immunotherapies, this review emphasizes the need for novel combination regimens and robust predictive biomarkers to improve clinical outcomes and extend survival in advanced NSCLC.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1610998/fulllung cancertumor microenvironmentimmune cellsimmunotherapyCD8 + T cellB cell
spellingShingle Haiyi Xue
Yilan Fan
Yi Li
Qian Zhao
Xuelu Zhang
Pei Zhao
Zhenjun Liu
Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
Frontiers in Immunology
lung cancer
tumor microenvironment
immune cells
immunotherapy
CD8 + T cell
B cell
title Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
title_full Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
title_fullStr Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
title_full_unstemmed Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
title_short Tumor-infiltrating lymphocytes in NSCLC: from immune surveillance to immunotherapy
title_sort tumor infiltrating lymphocytes in nsclc from immune surveillance to immunotherapy
topic lung cancer
tumor microenvironment
immune cells
immunotherapy
CD8 + T cell
B cell
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1610998/full
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AT yili tumorinfiltratinglymphocytesinnsclcfromimmunesurveillancetoimmunotherapy
AT qianzhao tumorinfiltratinglymphocytesinnsclcfromimmunesurveillancetoimmunotherapy
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