Objective:

To examine the existing literature on long non-coding RNAs (lncRNAs) as potential biomarkers of prognosis and response to immune checkpoint inhibitors (ICIs) in cancer treatment.

Approach:

• Systematic Review: Conducted according to PRISMA guidelines, registered in PROSPERO, and involved a comprehensive literature search from January 2010 to July 2025 for studies evaluating lncRNA expression in adult cancer patients treated with ICIs.

Key Findings:

• 31studiesacrossmultiplecancertypeswereincluded,primarilyretrospectivebioinformaticanalysesofpublicdatasets.lncRNA-basedsignaturesshowedprognosticvaluebystratifyingpatientsintogroupswithsignificantlydifferentsurvivaloutcomes.VariationsinlncRNAexpressionwereassociatedwithdifferencesinICIresponseacrossvariouscancertypes.

Interpretation:

Further validation and standardized approaches are necessary for the clinical application of lncRNAs as prognostic and predictive biomarkers for ICI treatment.

Limitations:

• TheclinicaluseoflncRNAsasICIbiomarkersremainsheterogeneousduetotissue-specificexpressionandvariabilityinmethodologicalapproachesacrossstudies.

Conclusion:

Prospective validation and standardized analytical approaches are needed to support the clinical translation of lncRNAs in precision immuno-oncology.

Sources:

• Systematic Review Registration