Liu Siyuan, Hu Lihong, Hu Jiejie, Qin Chengdong, Jiang Chuner, Yu Yang
Department of Breast Surgery, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, 310022, Zhejiang, China.
Postgraduate training base Alliance of Wenzhou Medical University, Higher Education Park, Chashan street, Ouhai District, Wenzhou, 325035, Zhejiang, China.
Postgrad Med J. 2025 May 6. doi: 10.1093/postmj/qgaf065.
Immunotherapy is increasingly integral to breast cancer treatment, yet a subset develops resistance, partly mediated by macrophages and monocytes in the tumor immune microenvironment. While macrophages play essential roles in phagocytosis and pathogen clearance, their dual role in breast cancer-acting as both barriers to therapy and potential therapeutic targets-complicates treatment efficacy.
Tumor-associated macrophages, polarized by tumor-derived signals, promote cancer progression and metastasis. Monocytes, subdivided into CD14+CD16- and CD14+CD16+ subsets, exhibit distinct functional profiles in cytokine secretion, antigen presentation, and migration. Modulating monocyte subset dynamics and functionality may enhance immunotherapy responsiveness.
A multimodal strategy targeting macrophages, monocytes, and complementary immunotherapies offers promising avenues to overcome resistance. Further research into the heterogeneity and regulatory mechanisms of these cells is critical for developing optimized, safe immunotherapeutic protocols. This review underscores the necessity of combination immunotherapies to improve outcomes in breast cancer.
免疫疗法在乳腺癌治疗中日益重要，但仍有一部分患者会产生耐药性，部分原因是肿瘤免疫微环境中的巨噬细胞和单核细胞介导了这种耐药性。巨噬细胞在吞噬作用和病原体清除中发挥着重要作用，然而它们在乳腺癌中的双重作用——既是治疗的障碍又是潜在的治疗靶点——使治疗效果变得复杂。
由肿瘤衍生信号极化的肿瘤相关巨噬细胞促进癌症进展和转移。单核细胞可细分为CD14+CD16-和CD14+CD16+亚群，它们在细胞因子分泌、抗原呈递和迁移方面表现出不同的功能特征。调节单核细胞亚群的动态变化和功能可能会增强免疫治疗的反应性。
针对巨噬细胞、单核细胞以及互补免疫疗法的多模式策略为克服耐药性提供了有前景的途径。进一步研究这些细胞的异质性和调节机制对于制定优化、安全的免疫治疗方案至关重要。本综述强调了联合免疫疗法改善乳腺癌治疗结果的必要性。
