Figure 3.

Summary of the main differences between the immune responses of males and females to NSCLC tumor cells. A more proficient immune system in women sets a better immune response to the tumor cells in the initial stages of disease. However, tumor cells acquire more resistance mechanisms to act against the immune response over time, meaning that the metastatic setting immune cells in women do not respond as efficiently as they do in men. In the case of men, the immune system is not as proficient, and tumor mutational burden is higher due to factors like higher tobacco consumption. Those factors mean that the tumor requires less immune evasion mechanisms to become metastatic, but suggest that the TME becomes more immunogenic and develops a more favorable response to ICIs. TCR: T-Cell Receptor; TIL: tumor infiltration lymphocyte; TME: tumor microenvironment; ICI: immune checkpoint inhibitor.