Research progress of extracellular vesicles as biomarkers in immunotherapy for non-small cell lung cancer

Lung cancer is one of the most severe forms of malignancy and a leading cause of cancer-related death worldwide, of which non-small cell lung cancer (NSCLC) is the most primary type observed in the clinic. NSCLC is mainly treated with surgery, radiotherapy, and chemotherapy. Additionally, targeted therapy and immunotherapy have also shown promising results. Several immunotherapies, including immune checkpoint inhibitors, have been developed for clinical use and have benefited patients with NSCLC. However, immunotherapy faces several challenges like poor response and unknown effective population. It is essential to identify novel predictive markers to further advance precision immunotherapy for NSCLC. Extracellular vesicles (EVs) present an important research direction. In this review, we focus on the role of EVs as a biomarker in NSCLC immunotherapy considering various perspectives, including the definition and properties of EVs, their role as biomarkers in current NSCLC immunotherapy, and different EV components as biomarkers in NSCLC immunotherapy research. We describe the cross-talk between the role of EVs as biomarkers and novel technical approaches or research concepts in NSCLC immunotherapy, such as neoadjuvants, multi-omics analysis, and the tumour microenvironment. This review will provide a reference for future research to improve the benefits of immunotherapy for patients with NSCLC.

Automated summary

Lung cancer, especially non-small cell lung cancer (NSCLC), is a severe and common type of cancer worldwide. NSCLC is typically treated with surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. However, immunotherapy still faces challenges, such as poor response rates and uncertainty in identifying effective populations. This review focuses on the role of extracellular vesicles (EVs) as biomarkers in NSCLC immunotherapy and discusses their definition, properties, and different components as potential biomarkers. It also explores the interaction between EVs as biomarkers and novel approaches or concepts in NSCLC immunotherapy research, providing insights for improving the benefits of immunotherapy for NSCLC patients.