Giorgia Novero, Chiara Pallisco, Rocco Schiavone, Enrica Milanesi, Massimo Di Maio, Tiziana Vavalà

Abstract. Summary. Lung cancer is the leading cause of death worldwide, and sexual dimorphism has emerged as a relevant topic in non-small cell lung cancer (NSCLC). While social and economic factors are known to influence disease incidence and mortality between sexes, increasing attention has been devoted to biological differences that may account for distinct tumor behavior and differential responses to treatment. This review comprehensively analyzes the current evidence on sex-related differences in lung cancer, with particular attention to genetic factors, hormonal influences, obesity, and immune response disparities. Available evidence on sex differences in response to anticancer therapies, including chemotherapy, immunotherapy, and targeted therapies, has been analyzed. Finally, future perspectives have been highlighted, focusing on emerging topics and commenting on the implications of these findings for personalized sex-based medicine.
Key words. Sex characteristics, non-small-cell lung cancer, hormones, immunotherapy.