Psychological distress influences lung cancer: Advances and perspectives on the immune system and immunotherapy

•Catecholamine- and neurotransmitter-activated signaling pathways from PD acts onimmune and tumor cells.•Mechanistically, β-AR signaling pathways altered lung cancer progress.•Activation of β2-AR promotes pro-inflammation by altering the balance of the immune system.•PD inhibit cancer immune therapy by activating cAMP-related pathway of β2-AR in CSCs.•Reducing PD in lung cancer patients facilitated lung cancer patients’ survival. Lung cancer has the highest incidence rate and mortality worldwide. Moreover, multiple factors may cause heterogeneity in the efficacy of immunotherapy for lung cancer, and preclinical studies have gradually uncovered the promotive effects of psychological distress (PD) on tumor hallmarks. Therefore, treatment targeted at PD may be a vital factor in adjusting and improving immunotherapy for lung cancer. Here, by focusing on the central nervous system, as well as stress-related crucial neurotransmitters and hormones, we highlight the effects of PD on the lung immune system, the lung tumor microenvironment (TME) and immunotherapy, which brings a practicable means and psychosocial perspective to lung cancer treatment.