Immunocompetent tumor-on-a-chip platforms offer essential tools for understanding cancer-immune biology and accelerating personalized immunotherapy development

The crosstalk between cancer cells and the immune system within the tumor microenvironment (TME) governs the efficacy of immunotherapeutic interventions. However, conventional preclinical models fail to recapitulate these dynamic processes. Microphysiological systems, particularly immunocompetent tumor-on-a-chip (TOC) platforms, bridge the gap between simplified two-dimensional cultures and animal models. These devices integrate microfluidic engineering, biomimetic extracellular matrices, and controlled perfusion. These platforms effectively recapitulate the cellular heterogeneity, three-dimensional structure, and physiological flow conditions of the TME. This review examines the engineering principles of immunocompetent TOC platforms and their applications in cancer immunotherapy research. These systems enable mechanistic studies of the cancer-immunity cycle, including immune cell recruitment, migration, and tumor cell cytotoxicity. They are particularly valuable for evaluating cell-based immunotherapies, including CAR-T cells. TOC platforms also facilitate drug screening and the testing of combination therapies. They show promise for functional precision oncology when integrated with patient-derived cells. Recent advances have extended these models toward greater physiological complexity. For example, multi-organ-on-a-chip systems capture systemic interactions, while lymph node-on-a-chip platforms enable studies of immune activation, and additionally organ-specific models mimic metastatic sites. Despite their potential, challenges remain in standardization, clinical validation, and balancing complexity with experimental control. As the field addresses these limitations through collaboration and integration with advanced analytics, immunocompetent TOC platforms are poised to become essential tools for understanding cancer-immune biology and accelerating personalized immunotherapy