Significant advancements have been made in the application of chimeric antigen receptor (CAR)-T treatment for blood cancers during the previous ten years. However, its effectiveness in treating solid tumors is still lacking, necessitating the exploration of alternative immunotherapies that can overcome the significant challenges faced by current CAR-T cells. CAR-based immunotherapy against solid tumors shows promise with the emergence of macrophages, which possess robust phagocytic abilities, antigen-presenting functions, and the ability to modify the tumor microenvironment and stimulate adaptive responses. This paper presents a thorough examination of the latest progress in CAR-M therapy, covering both basic scientific studies and clinical trials. This study examines the primary obstacles hindering the realization of the complete potential of CAR-M therapy, as well as the potential strategies that can be employed to overcome these hurdles. With the emergence of revolutionary technologies like in situ genetic modification, synthetic biology techniques, and biomaterial-supported gene transfer, which provide a wider array of resources for manipulating tumor-associated macrophages, we suggest that combining these advanced methods will result in the creation of a new era of CAR-M therapy that demonstrates improved efficacy, safety, and availability.

中文翻译：

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癌症免疫治疗新时代：结合革命性技术增强CAR-M治疗


过去十年，嵌合抗原受体（CAR）-T 治疗血癌的应用取得了重大进展。然而，其治疗实体瘤的有效性仍然缺乏，因此需要探索替代免疫疗法来克服当前 CAR-T 细胞面临的重大挑战。随着巨噬细胞的出现，基于 CAR 的实体瘤免疫疗法显示出前景，巨噬细胞具有强大的吞噬能力、抗原呈递功能以及改变肿瘤微环境和刺激适应性反应的能力。本文全面审视了 CAR-M 疗法的最新进展，涵盖基础科学研究和临床试验。本研究探讨了阻碍实现 CAR-M 疗法全部潜力的主要障碍，以及可用于克服这些障碍的潜在策略。随着原位基因修饰、合成生物学技术和生物材料支持的基因转移等革命性技术的出现，为操纵肿瘤相关巨噬细胞提供了更广泛的资源，我们建议结合这些先进方法将导致创建CAR-M 疗法的新时代展现出更高的功效、安全性和可用性。