In solid tumors, tumor-associated macrophages (TAMs) are one of the most numerous populations and play an important role in the processes of tumor cell invasion, metastasis, and angiogenesis. Therefore, TAMs are considered promising diagnostic and prognostic biomarkers of tumors, and many attempts have been made to influence these cells as part of antitumor therapy. There are several key principles of action on ТАМs: the inhibition of monocyte/macrophage transition; the destruction of macrophages; the reprogramming of macrophage phenotypes (polarization of M2 macrophages to M1); the stimulation of phagocytic activity of macrophages and CAR-M therapy. Despite the large number of studies in this area, to date, there are no adequate approaches using antitumor therapy based on alterations in TAM functioning that would show high efficacy when administered in a mono-regimen for the treatment of malignant neoplasms. Studies devoted to the evaluation of the efficacy of drugs acting on TAMs are characterized by a small sample and the large heterogeneity of patient groups; in addition, in such studies, chemotherapy or immunotherapy is used, which significantly complicates the evaluation of the effectiveness of the agent acting on TAMs. In this review, we attempted to systematize the evidence on attempts to influence TAMs in malignancies such as lung cancer, breast cancer, colorectal cancer, cervical cancer, prostate cancer, gastric cancer, head and neck squamous cell cancer, and soft tissue sarcomas.
在实体肿瘤中，肿瘤相关巨噬细胞（TAMs）是数量最多的细胞群之一，在肿瘤细胞侵袭、转移和血管生成过程中发挥重要作用。因此，TAMs被视为极具潜力的肿瘤诊断和预后生物标志物，并且已有许多研究尝试通过调控这些细胞来开展抗肿瘤治疗。针对TAMs的作用机制主要包括以下几个关键方向：抑制单核细胞/巨噬细胞转化；清除巨噬细胞；重编程巨噬细胞表型（将M2型巨噬细胞极化为M1型）；刺激巨噬细胞的吞噬活性以及CAR-M疗法。尽管该领域已有大量研究，但迄今为止，尚未出现基于调控TAM功能的、在单药治疗恶性肿瘤时能展现高效力的理想抗肿瘤治疗方案。现有关于TAM靶向药物疗效评估的研究普遍存在样本量小、患者群体异质性大的特点；此外，这些研究常联合使用化疗或免疫疗法，这极大增加了评估TAM靶向药物本身疗效的复杂性。本综述系统梳理了针对肺癌、乳腺癌、结直肠癌、宫颈癌、前列腺癌、胃癌、头颈部鳞状细胞癌及软组织肉瘤等恶性肿瘤中调控TAMs的相关研究证据。
肿瘤(癌症)患者之家