Cancer associated fibroblast exosomes mediate lung cancer immunotherapy resistance: from basic mechanisms to new targets for clinical intervention
Description
ABSTRACT Lung cancer (LC) remains the most prevalent malignant tumor globally in terms of both incidence and mortality. While immune checkpoint inhibitors (ICIs) have significantly improved survival outcomes in some patients in recent years, the high prevalence of primary and acquired resistance substantially limits therapeutic efficacy. Emerging evidence indicates that exosomes derived from cancer-associated fibroblasts (CAFs) are implicated in immunotherapy resistance in lung cancer. This review summarizes the biological characteristics of lung CAF-derived exosomes, outlines their mechanistic roles in promoting immune evasion, evaluates their clinical impact on immunotherapy outcomes, and discusses emerging molecular targets for therapeutic intervention, thus guiding future research directions.