The DOI matches its Crossref record; 184 of the 184 references it cites were found in a registry or an index.
Cancer-Associated Fibroblasts and Tumor-Associated Macrophages in Cancer and Cancer Immunotherapy
Open accessAbstract
Our understanding of the tumor microenvironment (TME), including the interplay between tumor cells, stromal cells, immune cells, and extracellular matrix components, is mandatory for the innovation of new therapeutic approaches in cancer. The cell-cell communication within the TME plays a pivotal role in the evolution and progression of cancer. Cancer-associated fibroblasts (CAF) and tumor-associated macrophages (TAM) are major cell populations in the stroma of all solid tumors and often exert protumorigenic functions; however, the origin and precise functions of CAF and TAM are still incompletely understood. CAF and TAM hold significant potential as therapeutic targets to improve outcomes in oncology when combined with existing therapies. The regulation of CAF/TAM communication and/or their differentiation could be of high impact for improving the future targeted treatment strategies. Nevertheless, there is much scope for research and innovation in this field with regards to the development of novel drugs. In this review, we elaborate on the current knowledge on CAF and TAM in cancer and cancer immunotherapy. Additionally, by focusing on their heterogenous functions in different stages and types of cancer, we explore their role as potential therapeutic targets and highlight certain aspects of their functions that need further research.
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![Figure 2 Kaplan–Meier curves depicting overall survival for high and low TAM densities across different cancer types. Overall survival curves, merged data, various cancers. Gastric cancer: Kaplan–Meier overall survival curves for gastric cancer patients with high TAM density (> 671 cells in five 400x microscopic fields; green dotted line) and low density (< 671 cells in five 400x microscopic fields; green solid line). The TAM density in the tumor tissue was negatively associated with overall survival [p=0.0073; (86)]. Breast cancer: Kaplan–Meier curves showing significant correlation (p<0.001) with overall survival according to the numbers of M2 TAM (CD163 high: yellow dotted line; CD163 low: yellow solid line) (87). Multiple myeloma: overall survival outcome based on low and high CD163 TAM (≤ 55 per high power microscopic field; dotted blue line) showing significant survival difference (p<0.001) (88). Ovarian cancer: Kaplan–Meier survival curves comparing high and low M1 (CD80)/M2 (CD163) ratios in patients with ovarian cancer. Patients with an M1/M2 ratio ≥ 1.4 (solid red line) showed a significantly higher overall survival (p=0.02) than those with an M1/M2 ratio < 1.4 (dotted red line) (89).](/paper-figures/cb0d1527c8ae4af3a2882a17d8f82d74/cancer-associated-fibroblasts-and-tumor-associated-macrophages-in-cancer-and-figure-2.jpg)

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“Among the various stromal cells within the TME, fibroblasts constitute the dominant cellular mass [27,28,29,30].”
From Modeling Tumor Microenvironment Complexity In Vitro: Spheroids as Physiologically Relevant Tumor Models and Strategies for Their Analysis (2025) · cites this paper as [30]
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“Similarly, an initial expansion of local fibroblasts circumscribing early or premalignant lesions in response to tissue neoplasia was observed in mouse models and human tissue studies (14, 28, 29).”
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Macrophages at the interface of the co-evolving cancer ecosystem
Kloosterman, D. J., & Akkari, L. (2023) · Cell · doi:10.1016/j.cell.2023.02.020 · Cited by 452
Roles of tumor-associated macrophages in anti-PD-1/PD-L1 immunotherapy for solid cancers
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Lu, Q., Kou, D., Lou, S., Ashrafizadeh, M., Aref, A. R., Canadas, I., Tian, Y., Niu, X., Wang, Y., Torabian, P., et al. (2024) · Journal of Hematology & Oncology · doi:10.1186/s13045-024-01535-8 · Cited by 373
Tumor-associated macrophages: an effective player of the tumor microenvironment
Basak, U., Sarkar, T., Mukherjee, S., Chakraborty, S., Dutta, A., Dutta, S., Nayak, D., Kaushik, S., Das, T., & Sa, G. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1295257 · Cited by 356
Cancer-associated fibroblasts: The chief architect in the tumor microenvironment
Sarkar, M., Nguyen, T., Gundre, E., Ogunlusi, O., El-Sobky, M. H., Giri, B., & Sarkar, T. R. (2023) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2023.1089068 · Cited by 150
Metadata
- Authors
- Raskov, H., Orhan, A., Gaggar, S., & Gögenur, I.
- Affiliations
- Zealand University Hospital Køge (DK)
- University of Copenhagen (DK)
- Corresponding author
- Raskov, Hans
- Venue
- Frontiers in Oncology
- Publisher
- Frontiers Media SA
- Published
- 2021-05-20
- Volume
- 11
- Pages
- 668731-668731
- ISSN
- 2234-943X (ISSN-L)
- PMC
- PMC8172975
- OpenAlex
- W3163457197
- Cited by
- 150
- References
- 184
- Citations by year
- 2026: 29 · 2025: 32 · 2024: 37 · 2023: 26 · 2022: 20 · 2021: 6
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › TGF-β signaling in diseases
- Keywords
- cancer-associated fibroblasts, tumor-associated macrophages, tumor microenvironment, cancer immunotherapy, tumor stroma, therapeutic target, intercellular communication, extracellular matrix
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