Defining the tumor microenvironment of non-small cell lung cancer.

Journal: Immunology and cell biology

This review article focuses on advanced-stage non-small-cell lung cancer (NSCLC) in the era of immunotherapy and emphasizes why only a subset of patients derive durable benefit.

Key points:

  • NSCLC remains the leading cause of cancer death, and immunotherapy has significantly changed management, producing unprecedented, long-lasting responses in some patients with advanced disease.
  • Most patients do not respond or eventually develop resistance. The authors attribute this in large part to tumor heterogeneity and the complex, dynamic tumor microenvironment (TME).
  • The review describes major components and features of the TME that drive cancer progression and immune evasion, underscoring their role in immunotherapy resistance.
  • Emerging technologies are highlighted—especially spatial tissue profiling—that allow detailed, in situ characterization of cellular and molecular interactions within the TME, improving understanding of tumor–immune dynamics.
  • The authors summarize current and evolving immunotherapeutic approaches and other novel treatment strategies, and discuss how these can be integrated with biomarker-driven patient selection.
  • A strong emphasis is placed on predictive biomarker testing and precision medicine, with the goal of tailoring therapy, overcoming resistance, and improving long-term outcomes in NSCLC.

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