Abstract
<jats:p>Introduction. Adipose tissue is an active metabolic and immunoregulatory organ that plays an important role in carcinogenesis and in shaping the response to anticancer therapy. In modern oncology, growing attention is being paid to its structural and functional characteristics as potential sources of prognostic biomarkers, particularly in the context of radiomics and immunotherapy in non-small cell lung cancer. Aim of the study. To analyze current data on the biological properties of adipose tissue, its role in the development of malignant neoplasms, and the potential use of orbital adipose tissue as a source of prognostic radiomic biomarkers in clinical oncology. A review of contemporary scientific publications indexed in PubMed (2021–2026) was conducted. Results. It has been established that adipose tissue functions as a complex metabolically active system regulating energy homeostasis, immune responses, and inflammatory processes. Its dysfunction is associated with the development of chronic low-grade inflammation, immune dysregulation, and the formation of a tumor-promoting microenvironment. It has been proven that body composition parameters, particularly the ratio of adipose to muscle mass, are associated with the effectiveness of PD-1/PD-L1 inhibitor immunotherapy in patients with non-small cell lung cancer. Radiomic features of adipose tissue (density, volume, and textural heterogeneity) may reflect its metabolic and inflammatory state and have prognostic value in oncology. Additionally, changes in radiomic parameters have been shown to correlate with systemic inflammation levels and tumor aggressiveness, further expanding their diagnostic potential. It has been demonstrated that different adipose tissue depots exhibit distinct biological activity, with visceral fat showing a more pronounced pro-inflammatory profile compared with subcutaneous fat, which may influence tumor progression. Orbital adipose tissue possesses unique anatomical and biological properties, characterized by stable visualization on computed tomography and reduced susceptibility to motion artifacts, making it a promising target for radiomic analysis. Its relative metabolic stability and well-defined structural organization provide prerequisites for improved reproducibility of radiomic parameters. It is also suggested that orbital fat may reflect systemic metabolic and immune alterations, serving as an integrative indicator of the organism’s status in malignant diseases. Conclusions. Orbital adipose tissue is considered a potential source of noninvasive prognostic biomarkers in oncology; however, its role requires further investigation.</jats:p>