# Integration of immunogenic cell death in the treatment landscape of non-small cell lung cancer: harnessing the power of the immune system

**Authors:** Zhe Liu, Xin Xu, Meijing Wang, Jianlei Zhang, Xuesong Zhao, Meina Wang, Fang Liu, Zhonghua Liu

PMC · DOI: 10.1038/s41420-026-03012-2 · Cell Death Discovery · 2026-03-18

## TL;DR

This paper reviews how immunogenic cell death can be used to improve non-small cell lung cancer treatment by activating the immune system against tumors.

## Contribution

The paper systematically summarizes ICD induction strategies and their preclinical and clinical progress in NSCLC.

## Key findings

- ICD activates the immune system by releasing damage-associated molecular patterns and triggering T cell responses.
- Preclinical trials show that therapies like chemotherapy and radiotherapy enhance antitumor effects through ICD induction.
- The paper highlights challenges and future directions for optimizing ICD-based NSCLC treatments.

## Abstract

Non-small cell lung cancer (NSCLC) accounts for 85% of lung cancer cases and is one of the leading causes of cancer-related death worldwide. Although traditional therapies such as chemotherapy, radiotherapy and molecular targeted therapy, as well as immunotherapy, have made substantial progress, drug resistance and tumour recurrence remain significant challenges. Immunogenic cell death (ICD), a special type of cell death, has emerged as a cutting-edge strategy for NSCLC treatment due to its unique immune activation mechanism. ICD orchestrates immunogenic tumour cell death via coordinated endoplasmic reticulum stress and reactive oxygen species generation, resulting in the release of damage-associated molecular patterns (DAMPs). Through a synergistic mechanism, tumour-associated antigens are unveiled, antigen-presenting cells such as dendritic cells are activated, and T cell responses targeting tumour-specific antigens are triggered. These factors collectively act to reprogramme the immunosuppressive tumour microenvironment (TME). Preclinical trials have demonstrated that chemotherapy, radiotherapy and molecular targeted therapy enhance the antitumour effect by inducing ICD, providing new strategies for treating NSCLC. This review systematically summarises the induction strategies of ICD in the treatment of NSCLC and focuses on the progress in preclinical experiments and clinical trials. Additionally, the current paper discusses the core challenges and future development directions of ICD in NSCLC therapy, to provide novel insights into the optimised utilisation and clinical implementation of ICD induction strategies.

## Linked entities

- **Diseases:** non-small cell lung cancer (MONDO:0005233), lung cancer (MONDO:0005138)

## Full-text entities

- **Genes:** BAK1 (BCL2 antagonist/killer 1) [NCBI Gene 578] {aka BAK, BAK-LIKE, BCL2L7, CDN1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, STING1 (stimulator of interferon response cGAMP interactor 1) [NCBI Gene 340061] {aka ERIS, MITA, MPYS, NET23, SAVI, STING}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, Akt1 (Akt serine/threonine kinase 1) [NCBI Gene 11651] {aka Akt, LTR-akt, PKB, PKB/Akt, PKBalpha, Rac}, PANX1 (pannexin 1) [NCBI Gene 24145] {aka MRS1, OOMD7, OZEMA7, PX1, UNQ2529}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, PARP1 (poly(ADP-ribose) polymerase 1) [NCBI Gene 142] {aka ADPRT, ADPRT 1, ADPRT1, ARTD1, PARP, PARP-1}, FPR2 (formyl peptide receptor 2) [NCBI Gene 2358] {aka ALX, ALXR, FMLP-R-II, FMLPX, FPR2A, FPRH1}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, AXL (AXL receptor tyrosine kinase) [NCBI Gene 558] {aka ARK, AXL3, JTK11, Tyro7, UFO}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, CALR (calreticulin) [NCBI Gene 811] {aka CALR1, CRT, HEL-S-99n, RO, SSA, cC1qR}, CEACAM5 (CEA cell adhesion molecule 5) [NCBI Gene 1048] {aka CD66e, CEA}, Prkn (parkin RBR E3 ubiquitin protein ligase) [NCBI Gene 50873] {aka Park2}, PPARD (peroxisome proliferator activated receptor delta) [NCBI Gene 5467] {aka FAAR, NR1C2, NUC1, NUCI, NUCII, PPARB}, TLR2 (toll like receptor 2) [NCBI Gene 7097] {aka CD282, TIL4}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, KDR (kinase insert domain receptor) [NCBI Gene 3791] {aka CD309, FLK1, VEGFR, VEGFR2}, PLK1 (polo like kinase 1) [NCBI Gene 5347] {aka PLK, STPK13}, TBK1 (TANK binding kinase 1) [NCBI Gene 29110] {aka AIARV, FTDALS4, IIAE8, NAK, T2K}, P2RX7 (purinergic receptor P2X 7) [NCBI Gene 5027] {aka P2X7}, Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, EIF2A (eukaryotic translation initiation factor 2A) [NCBI Gene 83939] {aka CDA02, EIF-2A, MST089, MSTP004, MSTP089}, ANXA1 (annexin A1) [NCBI Gene 301] {aka ANX1, LPC1}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, CASP8 (caspase 8) [NCBI Gene 841] {aka ALPS2B, CAP4, Casp-8, FLICE, MACH, MCH5}, IFNB1 (interferon beta 1) [NCBI Gene 3456] {aka IFB, IFF, IFN-beta, IFNB}, HSPA4 (heat shock protein family A (Hsp70) member 4) [NCBI Gene 3308] {aka APG-2, HEL-S-5a, HS24/P52, HSPH2, RY, hsp70}, HSP90AA1 (heat shock protein 90 alpha family class A member 1) [NCBI Gene 3320] {aka EL52, HEL-S-65p, HSP86, HSP89A, HSP90A, HSP90N}, Hmgb1 (high mobility group box 1) [NCBI Gene 15289] {aka HMG-1, Hmg1, SBP-1, p30}, HMGB1 (high mobility group box 1) [NCBI Gene 3146] {aka HMG-1, HMG1, HMG3, SBP-1}, GZMB (granzyme B) [NCBI Gene 3002] {aka C11, CCPI, CGL-1, CGL1, CSP-B, CSPB}, BCAP31 (B cell receptor associated protein 31) [NCBI Gene 10134] {aka 6C6-AG, BAP31, CDM, DDCH, DELXQ28, DXS1357E}, FPR1 (formyl peptide receptor 1) [NCBI Gene 2357] {aka FMLP, FPR}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, ALK (ALK receptor tyrosine kinase) [NCBI Gene 238] {aka ALK1, CD246, NBLST3}, CGAS (cyclic GMP-AMP synthase) [NCBI Gene 115004] {aka C6orf150, D4, MB21D1, h-cGAS}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}, MYD88 (MYD88 innate immune signal transduction adaptor) [NCBI Gene 4615] {aka IMD68, MYD88D, WM1}, TLR3 (toll like receptor 3) [NCBI Gene 7098] {aka CD283, IIAE2, IMD83}, Sting1 (stimulator of interferon response cGAMP interactor 1) [NCBI Gene 72512] {aka 2610307O08Rik, ERIS, MPYS, Mita, STING, STING-beta}, LRP1 (LDL receptor related protein 1) [NCBI Gene 4035] {aka A2MR, APOER, APR, CD91, DDH3, IGFBP-3R}, TREX1 (three prime repair exonuclease 1) [NCBI Gene 11277] {aka AGS1, CRV, DRN3, HERNS, RVCLS}, EIF2AK3 (eukaryotic translation initiation factor 2 alpha kinase 3) [NCBI Gene 9451] {aka PEK, PERK, WRS}
- **Diseases:** metastasis (MESH:D009362), hypoxia (MESH:D000860), Tumour (MESH:D009369), vascular damage (MESH:D057772), ICD (MESH:D003643), pneumonitis (MESH:D011014), lung cancer (MESH:D008175), interstitial lung disease (MESH:D017563), anaemia (MESH:D000743), infection (MESH:D007239), febrile neutropenia (MESH:D064147), IB-IIIA disease (MESH:C562594), gastrointestinal reactions (MESH:D005767), mitochondrial depolarisation (MESH:D028361), inflammatory (MESH:D007249), hypersensitivity (MESH:D004342), stage III (MESH:D062706), NSCLC (MESH:D002289), breast cancer (MESH:D001943), cytotoxic (MESH:D064420), alopecia (MESH:D000505), neutropenia (MESH:D009503)
- **Chemicals:** H2O2 (MESH:D006861), DM4 (MESH:D008453), PTX (MESH:D017239), cGAMP (MESH:C584311), OH (MESH:C031356), MB (MESH:D008751), singlet oxygen (MESH:D026082), Anlotinib (MESH:C000625192), Anthracyclines (MESH:D018943), hypericin (MESH:C004965), ROS (MESH:D017382), Crizotinib (MESH:D000077547), 1O2 (-), taxanes (MESH:D043823), DOX (MESH:D004317), pembrolizumab (MESH:C582435), iridium (III) (MESH:D007495), cisplatin (MESH:D002945), Bemcentinib (MESH:C548378), durvalumab (MESH:C000613593), platinum (MESH:D010984), ZnO (MESH:D015034), Osimertinib (MESH:C000596361), Ceritinib (MESH:C586847), CARBO (MESH:D016190), DOC (MESH:D000077143), Metal (MESH:D008670), lipopolysaccharide (MESH:D008070), ATP (MESH:D000255)
- **Species:** Peptococcus (genus) [taxon 2740], Turicibacter (genus) [taxon 191303], Lacticaseibacillus rhamnosus (species) [taxon 47715], Mus musculus (house mouse, species) [taxon 10090], Akkermansia muciniphila (species) [taxon 239935], Desulfovibrio (genus) [taxon 872], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** T790M, serine/threonine
- **Cell lines:** A549 — Homo sapiens (Human), Lung adenocarcinoma, Cancer cell line (CVCL_0023), LLC — Mus musculus (Mouse), Malignant tumors of the mouse pulmonary system, Cancer cell line (CVCL_5653)

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC13039888/full.md

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13039888/full.md

## References

2 references — full list in the complete paper: https://tomesphere.com/paper/PMC13039888/full.md

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Source: https://tomesphere.com/paper/PMC13039888