Neuro-Immune Interactions in the Tumour Microenvironment: Implications for Cancer Progression and Treatment.

Abstract

The nervous and immune systems, once viewed as distinct biological networks, are now understood to be closely linked in regulating cancer development, progression, and responses to therapy. Neural structures infiltrate the tumour microenvironment and communicate with immune cells, influencing key processes such as tumour growth, invasion, and metastatic spread. Through neurotransmitters, neuropeptides, and continuous signalling between peripheral tissues and the brain, nerves affect immune cell recruitment, activity, and overall immune balance. Factors including psychological stress, circadian rhythm disturbances, and gut-brain communication further shape antitumour immune responses, highlighting the complexity of these interactions. Research suggests that neuronal signalling not only contributes to cancer-associated symptoms, such as pain, but also affects the efficacy of chemotherapy, radiotherapy, and immunotherapy. Neural biomarkers may provide prognostic value, while interventions targeting neural pathways could strengthen anticancer immunity. Nevertheless, major challenges remain, including cellular heterogeneity, dynamic spatial and temporal interactions, and the limitations of existing experimental models. Continued progress in molecular techniques, bioinformatics, and cross-disciplinary research will be crucial for clarifying these mechanisms. Investigating the neuro-immune-cancer interface offers significant potential for developing innovative treatment approaches that combine neuroscience, immunology, and oncology to enhance patient survival and quality of life.