The neuro-immune axis in cancer: from mechanisms to therapeutic opportunities

In recent years, neural mechanisms involved in tumor initiation, progression, and immune regulation have garnered growing attention, fueling the rapid advancement of the burgeoning interdisciplinary domain of neuro-oncology. As a central component of physiological homeostasis, the neurophysiological system also exerts significant influence on the development and dynamics of the tumor microenvironment via complex neuro-immune signaling. Studies have shown that neurotransmitters, neuropeptides, and their mediated signaling pathways can directly or indirectly affect the functional state of tumor-associated immune cells, notably B cells, T cells, macrophages, myeloid-derived suppressor cells, and dendritic cells, thereby contributing to tumor immune evasion. This review systematically summarizes recent advances in neuroimmune interactions within the tumor microenvironment, highlighting the therapeutic potential of neural targets such as β-adrenergic and acetylcholine receptors. It also evaluates the repurposing potential of existing neuroactive drugs in cancer immunotherapy and their future application prospects. Although research in this field is still in its early stages, a deeper understanding of neuro-immune interaction mechanisms is expected to provide new ideas and theoretical foundations for innovative cancer treatment strategies.