肺癌在人群中发病率很高，不幸的是，大多数情况下预后不良。世界卫生组织（WHO）根据其表型将肺肿瘤分为两种亚型：非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）。尽管化疗和放疗取得了进展，但 SCLC 治疗对于癌症复发往往不成功，这凸显了开发新治疗策略的必要性。在这篇综述中，我们描述了表征 SCLC 病理过程的遗传景观和肿瘤微环境，以及它们如何导致肿瘤免疫逃避。 SCLC 中涉及的免疫抑制机制是了解 SCLC 免疫治疗失败的关键因素，相反，这表明应研究新的信号通路（例如 cGAS/STING）作为可能的靶标，以刺激这种肺亚​​型的先天免疫反应癌症。因此，充分理解癌细胞的先天免疫对于成功治疗 SCLC 和改善患者预后的免疫疗法提出新的挑战至关重要。© 2024。作者。

Lung cancer has a significant incidence among the population and, unfortunately, has an unfavourable prognosis in most cases. The World Health Organization (WHO) classifies lung tumours into two subtypes based on their phenotype: the Non-Small Cell Lung Cancer (NSCLC) and the Small Cell Lung Cancer (SCLC). SCLC treatment, despite advances in chemotherapy and radiotherapy, is often unsuccessful for cancer recurrence highlighting the need to develop novel therapeutic strategies. In this review, we describe the genetic landscape and tumour microenvironment that characterize the pathological processes of SCLC and how they are responsible for tumour immune evasion. The immunosuppressive mechanisms engaged in SCLC are critical factors to understand the failure of immunotherapy in SCLC and, conversely, suggest that new signalling pathways, such as cGAS/STING, should be investigated as possible targets to stimulate an innate immune response in this subtype of lung cancer. The full comprehension of the innate immunity of cancer cells is thus crucial to open new challenges for successful immunotherapy in treating SCLC and improving patient outcomes.© 2024. The Author(s).