Myeloid-instructed CD14+CD4+ T cells within the tumor microenvironment are associated with TNFα signaling and prolonged survival in non-small cell lung cancer

The tumor microenvironment (TME) harbors a diverse array of innate and adaptive immune cells that can either support anti-tumor immunity or facilitate tumor progression. Among these, myeloid cells are key drivers of immunosuppression, yet therapeutic strategies targeting their function have achieved limited clinical success. A deeper understanding of the mechanisms by which immunosuppressive myeloid cells promote tumor progression is needed to guide the development of more effective treatments. Using spatial multi-omics analyses, we identified a population of myeloid-instructed CD14+ T cells present in both the tumor core and adjacent non-malignant lung tissue of patients with non-small cell lung cancer (NSCLC). CD4+ T cells acquired CD14 from myeloid cells by trogocytosis, resulting in an atypical T cell phenotype. High infiltration of CD14+CD4+ T cells in the tumor core was associated with poor patient survival. Spatial transcriptomics profiling revealed that tumors enriched in CD14+CD4+ T cells exhibited increased TNF signaling. Functional assays demonstrated that TNF enhanced trogocytosis, promoting the transfer of myeloid membrane components to CD4{square} T cells and driving the accumulation of CD14{square}CD4{square} T cells. These findings uncover a novel TNF-mediated mechanism of immunosuppression in the TME, whereby TNF promotes aberrant myeloid-T cell interactions that may contribute to tumor progression. This work highlights a previously unrecognized axis of innate-adaptive immune crosstalk in NSCLC and suggests that targeting TNF could disrupt this pathway, restore effective T cell function, and improve therapeutic outcomes.