Macrophages in colorectal cancer: Origin, function and significance of targeted therapy

Colorectal cancer (CRC) is a malignant tumor of the gastrointestinal tract whose development is influenced by numerous factors. The tumor microenvironment (TME) serves as a core participant in tumor initiation, progression, and therapeutic resistance. Tumor-associated macrophages (TAMs), as a critical component of the TME, are recognized as potential therapeutic targets in cancer therapy. However, the specific roles of TAMs in CRC remain controversial, and their functional complexity may be closely linked to their high plasticity. This review systematically explores the plasticity of TAMs by examining their origins, classifications, and manifestations in CRC, with a focus on elucidating the diverse mechanistic roles of TAMs in CRC progression. Additionally, this review systematically summarizes current CRC treatment strategies targeting TAMs. Collectively, these analyses aim to provide new perspectives for TAM-targeted CRC therapy, advance the development of precision-targeted strategies, and offer novel therapeutic targets for personalized treatment of CRC.