Antitumor effects of acupuncture and moxibustion: from immune modulation to tumor microenvironment remodeling

Acupuncture and moxibustion are evidence - based modalities derived from traditional Chinese medicine. They employ strategic needle insertion or moxa - derived thermal stimulation at specific acupoints to ameliorate pathological conditions. Robust clinical data have validated their efficacy in mitigating gastrointestinal dysfunction, chemotherapy - induced neuropathy, cancer - related fatigue, and radiation - induced xerostomia. Crucially, within immunosuppressive tumor microenvironments (TME), these interventions exert direct antitumor effects through multimodal immunomodulation (1): Potentiation of innate immunity via enhanced cytotoxicity of natural killer (NK) cells, polarization of macrophages toward the proinflammatory M1 phenotype, regulation of microglial function, and modulation of mast cell (MC) degranulation; (2) Reprogramming of adaptive immunity through restoration of the T helper 1 (Th1)/T helper 2 (Th2) balance and activation of cluster of differentiation 8 - positive (CD8⁺) T cells; (3) Remodeling of the TME by attenuating immunosuppressive networks (e.g., regulatory T cells ((Tregs), myeloid - derived suppressor cells ((MDSCs)) while enhancing effector cell infiltration. This review synthesizes mechanistic advances that demonstrate how acupuncture and moxibustion rebalance antitumor immunosurveillance, thereby positioning them as promising adjuvant modalities in integrative oncology.