Navigating toxicity in lung cancer immunotherapy: challenges and advances in Nano medicine drug delivery

Abstract Lung cancer is still among the most malignant cancers, with immunotherapy becoming a ground-breaking treatment option. The ICIs and other immunotherapeutic drugs usually cause severe immune-related adverse effects curtailing their therapeutic efficacy. Meeting this challenge, Nano medicine-based drug delivery systems have gained considerable interest as they hold the promise of increasing therapeutic benefits at the same time as reducing toxicity. This chapter discusses the complex balance between the effectiveness and toxicity of lung cancer immunotherapy, underlining the application of nanotechnology in maximizing drug delivery. Nano carriers like liposomes, polymeric nanoparticles, dendrites, and lipid-based systems have demonstrated the capacity to augment the bioavailability of pharmaceuticals, facilitating tumour-specific environments, and alleviating systemic side effects. Other options suggest that stimuli-responsive and ligand-functionalized Nano platforms can provide spatial control over the immune response by enhancing infiltration to the tumour site while reducing toxicity to healthy organs. On the battlegrounds of nanomedicine, inhibiting resistance mechanisms consolidated with immune checkpoint inhibitors and conventional chemotherapeutics has conferred better therapeutic responses upon the patient. Its stability, bio-distribution, and regulatory pathway concerns still challenge clinical translation. The chapter discusses recent advances in preclinical and clinical testing and describes the development of Nano medicine-based regulatory T-cell-directed immunotherapy for lung and lung-associated cancers. The problems concerning both toxicity and the application of nanotechnology for targeting therapy will open new avenues toward developing safer and more effective antitumor immunotherapeutic regimes for lung cancer.