The Role of Macrophages in Cancer Development and Therapy
Open accessAbstract
Macrophages are critical mediators of tissue homeostasis and influence various aspects of immunity. Tumor-associated macrophages are one of the main cellular components of the tumor microenvironment. Depending on their activation status, macrophages can exert a dual influence on tumorigenesis by either antagonizing the cytotoxic activity of immune cells or, less frequently, by enhancing antitumor responses. In most situations, TAMs suppress T cell recruitment and function or regulate other aspects of tumor immunity. The importance of TAMs targeting in cancer therapy is derived from the strong association between the high infiltration of TAMs in the tumor tissue with poor patient prognosis. Several macrophage-targeting approaches in anticancer therapy are developed, including TAM depletion, inhibition of new TAM differentiation, or re-education of TAM activation for cancer cell phagocytosis. In this review, we will describe the role of TAMs in tumor development, including such aspects as protumorigenic inflammation, immune suppression, neoangiogenesis, and enhancement of tissue invasion and distant metastasis. Furthermore, we will discuss therapeutic approaches that aim to deplete TAMs or, on the contrary, re-educate TAMs for cancer cell phagocytosis and antitumor immunity.
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Tumor-derived cues generally favor M2 polarization of macrophages, resulting in secretion of cytokines such as IL-4, IL-6, IL-1β, and TNFα that support tumor growth by enhancing proliferation, remodeling ECM, and inhibiting effector T-cell responses.
“Tumor-derived cues generally favor M2 polarization, resulting in the secretion of cytokines such as IL-4, IL-6, IL-1β, and TNFα. These cytokines support tumor growth by enhancing cellular proliferation, remodeling the ECM, and inhibiting effector T-cell responses. Thus, TAMs serve as both immunological suppressors and facilitators of malignant progression [70,71].”
From Modeling Tumor Microenvironment Complexity In Vitro: Spheroids as Physiologically Relevant Tumor Models and Strategies for Their Analysis (2025) · cites this paper as [70]
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Fernandes, B., Feltes, P. K., Luft, C., Nazario, L. R., Jeckel, C. M. M., Antunes, I. F., Elsinga, P. H., & de Vries, E. F. J. (2022) · EJNMMI Radiopharmacy and Chemistry · doi:10.1186/s41181-022-00163-2 · Cited by 19 · see citing works
Cérda, S. L., Fontana, F., Wang, S., Correia, A., Molinaro, G., Tello, R. P., Hirvonen, J. J., Celia, C., Barreto, G., & Santos, H. A. (2023) · Advanced Therapeutics · doi:10.1002/adtp.202300048 · Cited by 19 · see citing works
Singh, K., & Gautam, P. K. (2023) · BMC Cancer · doi:10.1186/s12885-023-11674-9 · Cited by 19 · see citing works
Defining and targeting macrophage heterogeneity in the mammary gland and breast cancer
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The role of SPP1 + TAMs in cancer: Impact on patient prognosis and future therapeutic targets
Li, X., Lian, J., & Lu, H. (2025) · International Journal of Cancer · doi:10.1002/ijc.70018 · Cited by 18 · see citing works
Tumor-educated cells in tumor microenvironment: Key drivers of immunotherapy resistance
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Towards Novel Gene and Cell Therapy Approaches for Cervical Cancer
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Dendritic cell vaccine of gliomas: challenges from bench to bed
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Breast Cancer Immune Landscape: Interplay Between Systemic and Local Immunity
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The Physiological and Therapeutic Role of CD47 in Macrophage Function and Cancer
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Naei, V. Y., Tubelleza, R., Monkman, J. H., Sadeghirad, H., Donovan, M. L., Blick, T., Wicher, A. Z., Bodbin, S. E., Viratham, A., Stad, R. K., et al. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-06186-y · Cited by 17 · see citing works
- Authors
- Cendrowicz, E., Sas, Z., Bremer, E., & Rygiel, T. P.
- Affiliations
- University Medical Center Groningen (NL)
- Medical University of Warsaw (PL)
- Corresponding author
- Rygiel, Tomasz P.
- Venue
- Cancers
- Publisher
- MDPI AG
- Published
- 2021-04-18
- Volume
- 13
- Issue
- 8
- Pages
- 1946
- ISSN
- 2072-6694 (ISSN-L)
- PMC
- PMC8073377
- OpenAlex
- W3156547118
- Cited by
- 332
- References
- 199
- Citations by year
- 2026: 33 · 2025: 68 · 2024: 106 · 2023: 72 · 2022: 42 · 2021: 11
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancers (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Fundacja na rzecz Nauki Polskiej (TEAM TECH/2016-1/8)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Life Sciences › Immunology and Microbiology › Immunology › Phagocytosis and Immune Regulation
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- tumor-associated macrophages, tumor microenvironment, TAM depletion, TAM reprogramming, tumor immunosuppression, neoangiogenesis, metastasis, antitumor immunity, T cell recruitment
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