# The B-cell-autoantibody axis in lung cancer immunity

## TL;DR

This paper explores how B-cells and autoantibodies influence lung cancer immunity and treatment resistance, offering new strategies for immunotherapy.

## Contribution

The paper integrates scRNA-seq and spatial transcriptomics to reveal the dynamic roles of B-cells and autoantibodies in lung cancer.

## Key findings

- Tumor-infiltrating B lymphocytes and TLSs show functional plasticity depending on TLS maturation status.
- Autoantibodies regulate the tumor immune microenvironment through complement activation and ADCC.
- Targeting the B-cell-autoantibody axis could improve resistance to immunotherapy in NSCLC.

## Abstract

Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality, and while immune checkpoint inhibitor (ICI) has transformed treatment, resistance remains a critical challenge. Beyond the T-cell-centric view, tumor-infiltrating B lymphocytes (TIL-Bs) and tertiary lymphoid structures (TLSs) have emerged as pivotal prognostic determinants; however, the mechanistic interplay within the B-cell-autoantibody axis remains underexplored. Unlike previous reviews that primarily catalogue B-cell abundance, this synthesis integrates emerging evidence from single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics to dissect the spatiotemporal dynamics of B-cell subsets. We elucidate how the maturation status of TLSs dictates the functional plasticity of TIL-Bs, switching between anti-tumor effector phenotypes (e.g., antibody-secreting plasma cells) and pro-tumor regulatory roles (e.g., IL-10+ regulatory B cells). Furthermore, we systematically examine the dualistic role of autoantibodies—not merely as serological biomarkers but as active regulators of the tumor immune microenvironment (TIME) through complement activation and antibody-dependent cell-mediated cytotoxicity (ADCC). Finally, we highlight the clinical and translational implications of targeting this axis, proposing precision strategies such as B-cell-based vaccines and the modulation of TLS neogenesis to overcome ICIs resistance. This review provides a comprehensive roadmap for integrating B-cell biology into next-generation personalized immunotherapy for NSCLC.