免疫疗法是目前最有前途的肺癌临床治疗方法，不仅彻底改变了二线治疗，而且现在也被批准用于一线治疗。但其临床有效率并不高，并非所有患者都能受益。因此，寻找最佳组合策略来扩大基于抗PD-1/PD-L1的免疫治疗是目前的研究热点。化疗药物和靶向药物的常规使用不可避免地会产生耐药性、毒副作用等问题。然而最近的研究表明，通过调整药物剂量、阻断依赖于获得性耐药的突变机制的激活，有可能减少毒副作用、激活免疫细胞、重塑肺癌的免疫微环境。在此，我们讨论不同化疗药物和靶向药物对免疫微环境的影响。我们探讨了调整给药顺序和时间的效果以及此类反应的机制，并展示了联合免疫疗法的有效性和可靠性如何改善治疗结果。版权所有 © 2023 Wang、Du、Jiang、Chen 和 Wang。

Immunotherapy is currently the most promising clinical treatment for lung cancer, not only revolutionizing second-line therapy but now also approved for first-line treatment. However, its clinical efficiency is not high and not all patients benefit from it. Thus, finding the best combination strategy to expand anti-PD-1/PD-L1-based immunotherapy is now a hot research topic. The conventional use of chemotherapeutic drugs and targeted drugs inevitably leads to resistance, toxic side effects and other problems. Recent research, however, suggests that by adjusting the dosage of drugs and blocking the activation of mutational mechanisms that depend on acquired resistance, it is possible to reduce toxic side effects, activate immune cells, and reshape the immune microenvironment of lung cancer. Here, we discuss the effects of different chemotherapeutic drugs and targeted drugs on the immune microenvironment. We explore the effects of adjusting the dosing sequence and timing, and the mechanisms of such responses, and show how the effectiveness and reliability of combined immunotherapy provide improved treatment outcomes.Copyright © 2023 Wang, Du, Jiang, Chen and Wang.