[Toward novel therapeutic strategies: Targeting the extracellular matrix to broaden the therapeutic window]

Lung cancer is a major public health concern, ranking as the third most common cancer in women and the second in men, entailing significant mortality. Immune checkpoint inhibitors (ICIs, anti-PD-1/PD-L1) have transformed the treatment of advanced lung adenocarcinoma, thereby prolonging survival. However, many patients develop therapeutic resistance. Increased stiffness of the extracellular matrix (ECM) of the tumor represents a critical obstacle to immunotherapy efficacy, limiting lymphocyte infiltration. Modulation through integrins of the mechanical properties of the ECM could restore immune accessibility and potentiate ICIs, opening new therapeutic perspectives for treatment of advanced lung cancer.