Macrophages in prostate cancer: dual roles in tumor progression and immune evasion

Prostate malignant tumors are notably common within the male urinary tract and present significant challenges in medical treatment. A crucial aspect of understanding the progression of these tumors involves examining the immune microenvironment, particularly the multifaceted role played by macrophages. These immune cells have dual functions: on the one hand, they can inhibit tumor growth, while on the other hand, they can also facilitate and accelerate the progression of prostate cancer. Investigations have shed light on the mechanisms through which macrophages contribute to cancer promotion. These mechanisms include their involvement in mediating inflammatory responses, the secretion of chemokines that attract other immune cells, and the production of macrophage extracellular traps (METs), all of which may create favorable environments for tumor development. In the context of advanced prostate cancer, immunotherapy has emerged as the primary treatment modality. However, the effectiveness of this approach often falls short, leading to disheartening prognoses for patients undergoing such therapies. The suboptimal efficacy and poor outcomes associated with immunotherapy may be correlated with the activity of macrophages within the tumor microenvironment (TME). Specifically, the infiltration of macrophages into tumor tissues, along with elevated levels of these cells in the peripheral blood, has been identified as an indicator of a poor prognosis for individuals with prostate cancer. This study provides a deeper understanding of the cancer-promoting effects of macrophages and the various mechanisms by which they operate, including the roles of chemokines and the production of macrophage extracellular traps in both the onset and progression of prostate cancer. Furthermore, we explored how these factors are related to local tumor infiltration and systemic macrophage counts, which are associated with unfavorable survival outcomes for patients with this disease.