The nervous system has a dual role in regulating the immune system. It detects and processes stimuli and directly influences host immunity through the secretion of neurotransmitters, neuropeptides, and hormones. As a result, the nervous system affects tissue growth, maintenance, and differentiation in both health and disease, including cancer (Yaniv et al., 2024). Within tumors, peripheral and central neural circuits interact with immune compartments to reprogram the tumor immune microenvironment (TIME), where cytotoxic CD8+ T cells and natural killer (NK) cells counterbalance immunosuppressive Tregs and myeloid-derived suppressor cells (MDSCs). Moreover, M2-like tumor-associated macrophages (TAMs) are regulated by checkpoints, cytokines, and chemokines (Gysler and Drapkin, 2021, Binnewies et al., 2018, Gajewski et al., 2013). Evidence shows that tumor innervation and neural inputs influence antigen presentation, chemotaxis, metabolic programming, and checkpoint expression in myeloid and lymphoid cells. As shown in the relevant literature, cytokines from the immune system cause bidirectional changes in neuronal survival, excitability, and neuritogenesis. This creates a bidirectional neuro-immune axis that impacts cancer development, progression, and therapy response (Khanmammadova et al., 2023, Winkler et al., 2023). This framework supports integrating neural biology into immuno-oncology to explain TIME heterogeneity and to develop combined neural modulation and immune strategies (Winkler et al., 2023).