Spatial multi-omics analyses of the tumor immune microenvironment: advances and novel therapeutic avenues.

The tumor immune microenvironment (TIME) is a spatially organized ecosystem in which the distribution and interaction of cellular and molecular components have a significant impact on disease progression and therapeutic response. Traditionally, bulk analyses have failed to capture the critical spatial context governing these dynamics. The latest breakthroughs in spatial multi-omics technologies, including spatial transcriptomics, proteomics and metabolomics, have completely transformed our ability to characterize the TIME at unprecedented resolution. These advanced platforms enable precise mapping of immune cell distribution, reconstruction of intercellular communication networks, and identification of pattern structures such as tertiary lymphoid structures (TLS). We reviewed the current experimental methods of spatial omics and highlights how their applications provide novel insights into tumor biology. We further discussed how insights from spatial profiling could inform the development of novel therapeutic strategies aimed at actively remodeling the TIME, provide information for prognosis prediction, and shape responses to treatments such as immunotherapy. Despite the challenges in standardization and clinical translation, spatial multi-omics provides an indispensable dimension for understanding tumor immunobiology, paving the way for more precise tumor diagnosis, prognosis and treatment methods.