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Hypoxia promotes the expression of immunosuppressive molecules such as vascular endothelial growth factor (VEGF), TGF-, IL-10, and PD-L1 and induces the recruitment of cancer-associated fibroblasts (CAF) to facilitate the infiltration of myeloid-derived suppressor cells (MDSCs), Tregs, and type 2 tumor-associated macrophages (TAMs) via hypoxia-induced metabolic alterations in the tumor and TME [254, 255]

Finally, reference lists of retrieved studies were hand searched to identify any additional relevant studies

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Of the group, some 66,792, or 18.9%, said they were current cigarette smokers