Prognostic significance of peripheral blood immune response in early-stage non-small cell lung cancer: a narrative review

Abstract

: Recurrence rates after complete resection of early-stage non-small cell lung cancer (NSCLC) remain high despite advances in earlier diagnosis with increased low-dose CT screening. While previous efforts have illustrated the role of the immune response in the tumor microenvironment, a thorough understanding of the impact of the systemic immune response in early-stage NSCLC is still lacking and needed. Elaborating on the associations between the peripheral immune response and clinical outcomes is essential for risk stratification and for developing effective immunotherapeutic strategies to improve long term patient outcomes. In addition, measuring the association between immune markers in the blood and patient’s response to the disease provides a valuable opportunity for caregivers to gain prognostic information by simple and inexpensive blood draws, without the need to invasively access the tumor microenvironment. The role of these peripheral blood biomarkers has been extensively studied in a variety of solid tumors; however, the prognostic value of many immune markers in NSCLC is less well-defined. Herein, we review the role of the immune cells involved in the peripheral immune response to NSCLC and the prognostic significance of clinical biomarkers that can be measured inexpensively without access to the tumor microenvironment. This comprehensive review lays the groundwork for further research into the prognostic utility of immune markers found in the peripheral blood of NSCLC.