Tumors accumulated with infiltrated immune cells (hot-tumors) have a higher response rate to immune checkpoint blockade, when compared to those with minimal T cell infiltration (cold-tumors). We report here that lung cancer patients with different racial backgrounds harbored distinct immune cell profiles in the tumor microenvironment. Compared to African Americans (AAs), Caucasian Americans (CAs) exhibited increased immune cell infiltration and vasculature, and increased survival. Changes of survival and immune profile were most pronounced among active smokers and non-smokers, compared to former smokers and total patients. Neighborhood analysis showed that immune cells accumulated around cancer cells in CAs but not AAs. Our findings reveal intrinsic biological differences between AA and CA lung cancer patients, suggesting that treatment plans should be tailored for patients with different racial backgrounds.

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