Research advances on tumor-associated macrophages in pancreatic cancer

Pancreatic cancer, as a highly malignant tumor, is often regarded as one of the cancers with the poorest prognosis due to its insidious early symptoms, aggressive nature, and extremely poor clinical outcomes. Within the immune microenvironment of pancreatic cancer, tumor-associated macrophages (TAMs) constitute the predominant and central type of immune cell. They play a crucial regulatory role in key processes such as tumor initiation, progression, angiogenesis, and immune evasion. Furthermore, TAMs are deeply involved in regulating the onset and progression of the disease through multiple mechanisms, including the secretion of pro-inflammatory cytokines, promotion of tumor cell proliferation, and suppression of anti-tumor immune responses. At the same time, interventions targeting TAMs have demonstrated significant potential therapeutic value in preclinical and clinical studies. Therefore, this article aims to provide a comprehensive and systematic review of the origin and bidirectional interactions of TAMs in the progression of pancreatic cancer. Additionally, it will summarize and critically discuss the current status, challenges, and future prospects of research into related targeted therapeutic strategies, offering valuable insights for the development of novel immunotherapeutic approaches against this devastating disease.