ABSTRACT Tumoural-CD8 + T cells exhibit exhausted or dysfunctional states. Contrary to immunotherapy-responsive exhausted-CD8 + T cells, the clinical features of dysfunctional-CD8 + T cells are disputed. Hence, we conducted large-scale multi-omics and multi-dimensional mapping of CD8 + T cell-states across multiple cancer patient-cohorts. This identified tumour-specific continuum of CD8 + T cell-states across 6 human cancers, partly imprinted by organ-specific immuno-modulatory niches. Herein, melanoma and glioblastoma enriched prototypical exhausted (CD8 + T EXT ) and severely-dysfunctional (CD8 + T SDF ) states, respectively. Contrary to CD8 + T EXT , CD8 + T SDF displayed transcriptomic and epigenetic effector/cytolytic dysfunctions, and dysregulated effector/memory single-cell trajectories, culminating into maladaptive prodeath stress and cell-cycle defects. Suboptimal antigen-priming underscored CD8 + T SDF , which was distinct from immune-checkpoints “rich” CD8 + T EXT , reflecting chronic antigen-stimulation. Continuum variation also existed on tumour spatial-level, with convergent (CD8 + T EXT -supportive vascular regions) and divergent features (dysfunctional CD4 + T::CD8 + T SDF cell-to-cell interactions) between melanoma and glioblastoma. Globally, IFNγ-IL2 disparities, paucity of intra-tumoural CD4 + /CD8 + T cells, and myeloid TGFβ/wound healing responses, distinguished CD8 + T SDF -landscape. Within immuno-oncology clinical-trials, anti-PD1 immunotherapy failed to “reinvigorate” CD8 + T SDF -landscape, and instead facilitated effector-dysfunction and TGFβ/wound healing. However, cellular immunotherapies (dendritic cell-vaccines, adoptive T-cell therapy) ameliorated assorted CD8 + T SDF -landscape disparities, highlighting a roadmap for anti-glioblastoma multimodal-immunotherapy. Collectively, our study comprehensively expands clinical-knowledge on CD8 + T cell-exhaustion and suggests that tumour-specific, pre-existing CD8 + T EXT /T SDF -states, determine immunotherapy-responses.