肺癌（LC）是全球导致癌症相关死亡的主要原因之一，具有显著的发病率和死亡率，威胁人类生命和健康。免疫疗法的引入显著改变了现有的癌症治疗策略，并有望提高免疫应答、客观缓解率和生存率。然而，要进一步提高免疫疗法的疗效，需要更好地理解肺癌复杂的免疫网络。肿瘤相关抗原（TAAs）和肿瘤特异性抗原（TSAs）由肺癌细胞显著表达，激活树突状细胞，引发抗原呈递，并激活淋巴细胞发挥抗肿瘤活性。然而，随着肿瘤细胞与免疫系统相互作用，免疫抑制的微环境形成，导致一系列免疫逃逸机制的实施，包括免疫抑制细胞的招募和T细胞衰竭的诱导，以降低抗肿瘤免疫应答。除了肺癌细胞对免疫细胞功能的直接影响外，分泌各种细胞因子、趋化因子和外泌体，以及肿瘤内微生物组的变化，癌相关成纤维细胞和内皮细胞功能的改变也对肺癌细胞免疫逃逸起到贡献作用。因此，将各种免疫疗法与其他治疗方法相结合，可以通过对肿瘤微环境进行多靶点作用，从而在复杂的免疫网络基础上产生协同效应，提高免疫疗法的疗效。因此，本综述为理解肿瘤微环境中复杂的免疫网络并设计新颖有效的肺癌免疫疗法策略提供了指导。版权所有 © 2023。Elsevier Masson SAS 发布。

Lung cancer (LC) is one of the leading causes of cancer-related deaths worldwide, with a significant morbidity and mortality rate, endangering human life and health. The introduction of immunotherapies has significantly altered existing cancer treatment strategies and is expected to improve immune responses, objective response rates, and survival rates. However, a better understanding of the complex immunological networks of LC is required to improve immunotherapy efficacy further. Tumor-associated antigens (TAAs) and tumor-specific antigens (TSAs) are significantly expressed by LC cells, which activate dendritic cells, initiate antigen presentation, and activate lymphocytes to exert antitumor activity. However, as tumor cells combat the immune system, an immunosuppressive microenvironment forms, enabling the enactment of a series of immunological escape mechanisms, including the recruitment of immunosuppressive cells and induction of T cell exhaustion to decrease the antitumor immune response. In addition to the direct effect of LC cells on immune cell function, the secreting various cytokines, chemokines, and exosomes, changes in the intratumoral microbiome and the function of cancer-associated fibroblasts and endothelial cells contribute to LC cell immune escape. Accordingly, combining various immunotherapies with other therapies can elicit synergistic effects based on the complex immune network, improving immunotherapy efficacy through multi-target action on the tumor microenvironment (TME). Hence, this review provides guidance for understanding the complex immune network in the TME and designing novel and effective immunotherapy strategies for LC.Copyright © 2023. Published by Elsevier Masson SAS.