Adjusting the dose of traditional drugs combined with immunotherapy: reshaping the immune microenvironment in lung cancer

Sep 24, 2026

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Immunotherapy has become a leading clinical option for lung cancer, but its benefits remain inconsistent and overall efficacy is limited for many patients. Conventional chemotherapy and targeted therapies often cause resistance and toxic side effects. By adjusting drug dosing and interrupting acquired-resistance–related mutational activation, combined regimens aim to reduce toxicity, stimulate immune cells, and remodel the tumor immune microenvironment. This review discusses how different chemotherapy and targeted drugs, plus dosing sequence and timing, influence mechanisms and treatment reliability.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Lung cancer burden and risk factors

Classification of lung cancer

Evolution of treatment approaches

Cancer immunotherapy and immune checkpoint inhibitors (ICIs)

TYPE Review PUBLISHED 09 October 2023 DOI 10.3389/fimmu.2023.1256740 OPEN ACCESS EDITED BY Cory L. Brooks, California State University, Fresno, United States REVIEWED BY Christophe Chassagnole, Physiomics plc, United Kingdom Qingxin Mu, University of Washington, United States *CORRESPONDENCE Zibing Wang [zlyywzb2118@zzu.edu.cn](zlyywzb2118@zzu.edu.cn)[ ](zlyywzb2118@zzu.edu.cn)Lin Chen [chenlin@gzhmu.edu.cn](chenlin@gzhmu.edu.cn) RECEIVED 11 July 2023 ACCEPTED 05 September 2023 PUBLISHED 09 October 2023 CITATION Wang L, Du C, Jiang B, Chen L and Wang Z (2023) Adjusting the dose of traditional drugs combined with immunotherapy: reshaping the immune microenvironment in lung cancer. Front. Immunol. 14:1256740 . doi: 10.3389/fimmu.2023.1256740 COPYRIGHT © 2023 Wang, Du, Jiang, Chen and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Adjusting the dose of traditional drugs combined with immunotherapy: reshaping the immune microenvironment in lung cancer Linlin Wang1,2, Changqi Du 2, Bing Jiang 2, Lin Chen 3* and Zibing Wang 1* 1 Department of Immunotherapy, Afﬁliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China, 2Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, China, 3Guangzhou Medical University-Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences, Guangdong-Hong Kong-Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China 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. KEYWORDS lung cancer, immune checkpoint inhibitors, immune microenviroment, drug dose adjustment, immunothearpy Frontiers in Immunology 01 [frontiersin.org](frontiersin.org) 1 Introduction According to the International Agency for Research on Cancer’s World Cancer Statistical Report, approximately 1.8 million deaths occur annually due to lung cancer, followed by rectal cancer, liver cancer, and stomach cancer (1) . Lung cancer is most prevalent among male patients and ranks second among female patients (2) due to its initial asymptomatic nature and difﬁculty in detection (3, 4) . Currently, lung cancer holds the highest incidence and mortality rate globally (5) . Smoking causes 80% of lung cancer deaths, while other risk factors include radon gas, asbestos, cumulative exposure to air pollution, polycyclic aromatic hydrocarbon emissions, and genetic factors (6) . Lung cancer is categ

FAQs

Why is improving immunotherapy combinations important in lung cancer?

Immunotherapy is promising but clinical efficiency is not high and not all patients benefit. Therefore, finding the best combination strategy to expand anti-PD-1/PD-L1-based immunotherapy is a major research focus.

How can adjusting traditional drug dosing affect the immune microenvironment?

The review suggests that adjusting dosage and blocking activation of acquired-resistance–dependent mechanisms can reduce toxic side effects, activate immune cells, and reshape the lung cancer immune microenvironment.

What does the review analyze regarding combined immunotherapy regimens?

It discusses effects of different chemotherapeutic and targeted drugs on the immune microenvironment, and explores how dosing sequence and timing influence mechanisms and the effectiveness and reliability of combined immunotherapy.

Sep 24, 2026

Uploaded by Grenda