尽管最近出现了免疫检查点抑制剂，但并非所有非小细胞肺癌 (NSCLC) 患者都能从免疫治疗中受益。这种变异性的原因取决于多种因素，这些因素可能允许识别新的生物标志物。目前，多种生物标志物正在研究中，包括 PD1/PDL1 轴、肿瘤突变负荷和微生物群。后者是由我们体内的所有细菌和其他微生物产生的。肠道微生物群是最具代表性的，并且参与了包括癌症在内的不同生理和病理事件。从这个角度来看，似乎所有改变肠道微生物群的条件都会影响癌症、其治疗及其治疗相关的毒性。本综述的目的是分析影响肠道微生物群的所有条件，从而影响 NSCLC 患者对免疫疗法、iRAE 及其治疗的反应。对这些生物事件的研究可以为非小细胞肺癌免疫治疗的最佳管理提供新的见解。

Despite the recent availability of immune checkpoint inhibitors, not all patients affected by Non-Small-Cell Lung Cancer (NSCLC) benefit from immunotherapy. The reason for this variability relies on a variety of factors which may allow for the identification of novel biomarkers. Presently, a variety of biomarkers are under investigation, including the PD1/PDL1 axis, the tumor mutational burden, and the microbiota. The latter is made by all the bacteria and other microorganisms hosted in our body. The gut microbiota is the most represented and has been involved in different physiological and pathological events, including cancer. In this light, it appears that all conditions modifying the gut microbiota can influence cancer, its treatment, and its treatment-related toxicities. The aim of this review is to analyze all the conditions influencing the gut microbiota and, therefore, affecting the response to immunotherapy, iRAEs, and their management in NSCLC patients. The investigation of the landscape of these biological events can allow for novel insights into the optimal management of NSCLC immunotherapy.