Senescent macrophages emerge as key drivers of tumor progression
A new review published (DOI: 10.20892/j.issn.2095-3941.2024.0589) in Cancer Biology & Medicine by researchers at Shandong University takes an in-depth look at how aging macrophages—once thought to be passive bystanders—actively drive tumor development. Drawing on molecular biology, immunology, and emerging therapeutic strategies, the authors present the first comprehensive framework linking macrophage senescence to cancer. The study not only details the functional shifts that occur in these cells but also explores a range of cutting-edge treatments—including drugs that eliminate or reprogram them—offering new possibilities for cancer therapy.
Senescent macrophages undergo dramatic changes: they lose their tumor-fighting abilities and instead foster a microenvironment ripe for cancer growth. Marked by elevated levels of p16INK4a, p21, and SA-β-gal, these cells secrete pro-inflammatory factors like IL-6, IL-10, and VEGF, while exhibiting reduced antigen presentation and phagocytosis. Their shift toward an M2-likephenotype is accompanied by metabolic dysfunction and increased tissue infiltration—traits that undermine immune surveillance and promote metastasis. The review outlines three therapeutic approaches: senolytics, which selectively remove senescent macrophages; senomorphics, which suppress their harmful secretions (SASP); and senoreverters, which attempt to reverse their aged state. Promising agents include quercetin, fisetin, rapamycin, and even CAR-T cells designed to target aging markers. These treatments could reshape the tumor landscape by restoring immune balance and enhancing existing cancer therapies.
Therapeutic strategies that focus on senescent macrophages could play a transformative role in future cancer care. These aging cells are implicated in immune evasion and resistance to checkpoint inhibitors and chemotherapy. Combining senolytic or senomorphic treatments with standard therapies may enhance response rates and reduce recurrence. However, challenges remain: current biomarkers lack specificity, and senescent cells vary widely by tissue type. The review calls formulti-omics profilingand precision targeting to overcome these hurdles. As researchers decode the biology of aging within tumors, senescent macrophages may emerge not just as obstacles—but as strategic targets to tip the balance in favor of patients.
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