Neuro-immune cross-talk in cancer

The nervous and immune systems have co-evolved to detect and respond to internal and external threats, working together to restore homeostasis after tissue injury or infection. Sharing several receptors and ligands, they engage in direct cross-talk that substantially influences disease development. The emerging field of cancer neuro-immunity focuses on the intricate interactions between the nervous system, immune responses and tumour growth. Additional findings have revealed that nerve fibres infiltrating peripheral tumours can release neuromodulatory factors that shape both immune cell behaviour and tumour progression. Conversely, tumour-infiltrating immune cells can modify the activity of local neurons, including pain-transmitting nociceptive sensory neurons. Beyond sensory fibres, sympathetic signalling can foster immunosuppression by recruiting myeloid-derived suppressor cells and promoting T cell exhaustion. This Review summarizes current evidence on how neuronal signalling regulates peripheral antitumour immune responses within the tumour microenvironment. We describe the complex, reciprocal interactions among neurons, immune cells and malignant cells, highlighting the key parts played by the peripheral nervous system in modulating immunity against cancer. By understanding this neuro-immune axis, novel therapeutic approaches may be uncovered to strengthen antitumour immunity and enhance responses to existing cancer treatments. The nervous and immune systems have co-evolved to respond to threats, including cancer. In this Review, Amit et al. outline the reciprocal interactions among neurons, immune cells and tumour cells that regulate peripheral antitumour immune responses and discuss how these mechanisms could be leveraged to enhance immunotherapy.