Hepatocellular carcinoma (HCC) is a major global health issue characterized by poor prognosis and complex tumor biology. One of the critical components of the HCC tumor microenvironment (TME) is tumor-associated macrophages (TAMs), which play a pivotal role in modulating tumor growth, immune evasion, and metastasis. Macrophages are divided into two major subtypes: pro-inflammatory M1 and anti-inflammatory M2, both of which may exist in TME with altered function and proportion. The anti-inflammatory M2 macrophages are further subdivided into four distinct immune suppressive subsets. TAMs are generally counted as M2-like macrophages with altered immune suppressive functions that exert a significant influence on both cancer progression and the ability of tumors to escape immune surveillance. Their involvement in modulating immune responses via different mechanisms at the local and systemic levels has made them a key target for therapeutic interventions seeking to enhance treatment outcomes. How TAMs’ depletion influences immune responses in cancer is the primary interest in cancer immunotherapies. The purpose of this review is to delve into the recent progress made in TAM-targeting therapies. We will explore the current theories, benefits, and challenges associated with TAMs’ depletion or inhibition. The manuscript concludes with future directions and potential implications for clinical practice.
肝细胞癌（HCC）是一种全球性的重大健康问题，其特点是预后不良且肿瘤生物学机制复杂。肿瘤相关巨噬细胞（TAMs）是HCC肿瘤微环境（TME）中的关键组成部分，在调节肿瘤生长、免疫逃逸和转移过程中发挥着核心作用。巨噬细胞主要分为促炎性M1型和抗炎性M2型两种亚型，两者均可能存在于肿瘤微环境中，但其功能与比例会发生改变。抗炎性M2型巨噬细胞可进一步细分为四个具有免疫抑制功能的亚群。通常认为TAMs属于M2样巨噬细胞，其免疫抑制功能发生改变，对癌症进展及肿瘤逃避免疫监视的能力均产生显著影响。TAMs通过在局部和全身层面以不同机制调节免疫反应，已成为提升治疗效果的重要治疗靶点。TAMs的耗竭如何影响癌症免疫反应，是当前癌症免疫治疗研究的核心关注点。本综述旨在深入探讨靶向TAMs治疗策略的最新进展，系统阐述当前关于TAMs耗竭或抑制的理论基础、临床获益及面临的挑战，并对未来研究方向及临床实践的潜在意义进行展望。
肿瘤(癌症)患者之家