Immunotherapy has significantly improved clinical outcomes of non-small cell lung cancer (NSCLC), however, along with the popularization of immunotherapy, immune resistance has become an unavoidable problem. Immunotherapy can induce extensive cellular and molecular alterations in the tumor microenvironment. Considering the mechanisms of immune resistance are not yet fully understood and the efficacy of standard chemotherapy regimens is limited, more effective coping strategies based on resistance mechanisms are urgently needed. In this review, we intend to summarize the known mechanisms of immune resistance and feasible strategies, so as to provide a foundation for clinicians to develop more individualized and precise regimens and finally improve patients' prognosis.
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Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Lung Neoplasms/drug therapy* ; Prognosis ; Immunotherapy ; Tumor Microenvironment

Large cell neuroendocrine carcinoma(LCNEC)of lung is a rare neuroendocrine carcinoma subtype with difficulty in early diagnosis and poor prognosis which is treated with standard strategies of small cell lung cancer and non-small cell lung cancer.In recent years,the precise types of LCNEC and its response to therapy have been identified by next-generation sequencing.Some researches have also found the correlation between different subtypes of LCNEC and the efficacy of chemotherapy regimens.However,there is no consensual agreement of its therapy.Recently,immune checkpoint inhibitors(ICIs)has provided a new option for LCNEC patients based on some retrospective research data and case reports.In this review,we aimed to summarize the epidemiological characteristics,standard therapy,the advances of molecular subtypes and clinical applications of ICIs of LCNEC,so as to provide optimal systemic clinical decision-making for LCNEC patients.