Revisiting tumor vasculature in the era of cancer immunotherapy: from aberrant hallmark to therapeutic target.

Aberrant angiogenesis is a hallmark of cancer that promotes tumor progression and therapeutic resistance. The resulting tumor vasculature is structurally and functionally abnormal, leading to inadequate perfusion and hypoxia. Beyond supporting tumor growth, such vascular abnormalities also restrict immune cell infiltration and impair antitumor immune responses. Accordingly, tumor vasculature emerges as a potential target to improve therapeutic outcomes. This review summarizes the cellular composition, functional heterogeneity, and diverse types of tumor vasculature, as well as the crosstalk between abnormal blood vessels and immune cells. We further outline the current vascular-targeting approaches, with a particular focus on their immunomodulatory effects and synergistic potential with immunotherapies. Diagnostic classification of tumor vasculature, together with the combination of vascular-targeted therapy and immunotherapy, may offer new opportunities for precision tumor treatment.