Advances in tumor micro-environment and immunotherapy of squamous cell carcinoma of the tongue.

Tongue squamous cell carcinoma (TSCC), the most prevalent oral malignancy, demonstrates rising global incidence and mortality rates, while current therapies exhibit limited efficacy in advanced-stage disease. The tumor microenvironment (TME) constitutes an intricate ecosystem of immune cells, fibroblasts, and extracellular matrix (ECM), which collectively regulate TSCC progression, immune evasion, and therapeutic resistance. Tumor immunotherapies targeting TME have been increasingly validated in clinical trials, and despite the ability to capture relevant immune features in TME, challenges such as low individual response rates and immunotherapy resistance still exist in the clinic. In this review, we address the mechanisms of TSCC-associated immune cells as well as extracellular-related components in TME, summarize the effects of each component of TME on tumor immune response, and look forward to the application of tumor immunotherapy and immune-combination therapies to improve the efficacy of individualized precision medicine for TSCC.