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REVIEW article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

This article is part of the Research TopicCommunity Series in New Insights into Innate Immune Cell-Based Immunotherapies in Cancer: Volume IIView all 5 articles

The Significance of Trained Immunity in Cancer

Provisionally accepted
Zhiheng  SunZhiheng Sun1*Junxing  QuJunxing Qu2Xinya  GuoXinya Guo1Xinru  WangXinru Wang1Huiwen  MengHuiwen Meng1Peizhi  LiPeizhi Li3*
  • 1Henan Normal University, Xinxiang, China
  • 2Xinxiang Medical University, Xinxiang, China
  • 3Xinxiang First People's Hospital, Xinxiang, China

The final, formatted version of the article will be published soon.

Trained immunity (TI) represented a unique state of innate immune activation, characterized primarily by persistent epigenetic modifications in immune cells. This phenomenon was first observed during pathogen infections and vaccinations, where it manifested as enhanced defensive responses in innate immune effector cells—such as those of the mononuclear phagocyte system and natural killer cells—upon re-stimulation. Cancer was a disease with complex mechanisms, marked by the loss of normal growth regulation in cells due to genetic mutations or epigenetic dysregulation, leading to abnormal proliferation and dissemination. With hundreds of subtypes, cancer could arise in virtually any human tissue or organ. The primary cause of cancer-related mortality was metastasis, which referred to the spread of cancer cells from their original site to distant organs and accounted for approximately 90% of cancer deaths worldwide. The induction of TI involved multiple immune components including myeloid cells, natural killer cells, pattern recognition receptors, and various cytokines. Notably, the enhanced response observed during secondary stimulation remained nonspecific to particular pathogens. Compared to conventional therapeutic approaches, TI demonstrated superior systemic immune activation. Simple pharmacological stimuli such as β-glucan or Bacillus Calmette-Guérin (BCG) not only triggered innate immune responses but also conferred benefits to adaptive immunity, resulting in more rapid immune activation and enhanced efficacy. TI enhanced the capacity of immune cells to recognize and eliminate cancer cells, playing a critical role in countering metastasis. In this review, we summarized existing knowledge in the field, focusing on the mechanisms underlying TI induction and its significance in combating cancer.

Keywords: trained immunity, lung cancer, gastric cancer, liver cancer, colorectal cancer

Received: 13 Jul 2025; Accepted: 17 Nov 2025.

Copyright: © 2025 Sun, Qu, Guo, Wang, Meng and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Zhiheng Sun, sunzhiheng@htu.edu.cn
Peizhi Li, xxhw.0806@163.com

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