Anderson, RonaldBlidner, Ada GabrielaRapoport, Bernardo Leon2022-03-032022-03-032021-06-08Anderson, R., Blidner, A.G. & Rapoport, B.L. (2021) Review Manuscript Targeting of the Neutrophil as an Adjunctive Strategy in Non-Small Cell Lung Cancer. Frontiers in Pharmacology 12:676399. DOI: 10.3389/fphar.2021.676399.1663-9812 (online)10.3389/fphar.2021.676399http://hdl.handle.net/2263/84312Lung cancer remains the leading cause of cancer mortality in the United States, with non-small cell lung cancer (NSCLC) accounting for around 85% of cases. Of particular concern is the poor responsiveness of this malignancy to therapy, resulting in a very low 5-year survival rate (17.4%) and a prominent tendency to progress to metastatic disease. A number of very recent studies, both pre-clinical and clinical, have implicated the neutrophil in both the pathogenesis and unsatisfactory response to therapy of NSCLC. In this context, movement of neutrophils into the tumor microenvironment (TME) is a common feature of NSCLC. Indeed neutrophils are the dominant type of immune cell in the NSCLC TME, creating a highly immunosuppressive milieu that is not only conducive to tumor growth and spread, but also represents a significant obstacle to the success of anti-tumor therapy, especially novel immunotherapies. The clinically relevant adverse impact of a neutrophil predominance both systemically and in the TME of patients with NSCLC is underscored by the negative prognostic value of both a persistent neutrophilia and, in particular, a high (≥5) neutrophil: lymphocyte ratio. On a more positive note, however, recognition of the involvement of the neutrophil in both the pathophysiology of NSCLC and treatment failure has enabled identification of neutrophil-targeted strategies that have the potential to serve as adjuncts to standard anti-cancer therapies, including immunotherapy. These strategies together with a consideration of the immunosuppressive, pro-tumorigenic properties of the neutrophil represent the major thrusts of this review.en© 2021 Anderson, Blidner and Rapoport. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).Adjunctive therapyImmunosuppressionLung cancerMyeloid-derived suppressor cellsNeutrophilsTumor-associated neutrophilsNon-small cell lung cancer (NSCLC)Article