Abstract

The current review article describes the functional relationship between tumor-associated macrophages (TAM) as key cellular contributors to cancer malignancy on the one hand and macrophage-colony-stimulating factor (M-CSF or CSF-1) as an important molecular contributor on the other. We recapitulate the available data on expression of M-CSF and the M-CSF receptor (M-CSFR) in human tumor tissue as constituents of a stromal macrophage signature and on the limits of the predictive and prognostic value of plasma M-CSF levels. After providing an update on current insights into the nature of TAM heterogeneity at the level of M1/M2 phenotype and TAM subsets, we give an overview of experimental evidence, based on genetic, antibody-mediated, and pharmacological disruption of M-CSF/M-CSFR signaling, for the extent to which M-CSFR signaling can not only determine the TAM quantity, but can also contribute to shaping the phenotype and heterogeneity of TAM and other related tumor-infiltrating myeloid cells (TIM). Finally, we review the accumulating information on the – sometimes conflicting – effects blocking M-CSFR signaling may have on various aspects of cancer progression such as tumor growth, invasion, angiogenesis, metastasis, and resistance to therapy and we thereby discuss in how far these different effects actually reflect a contribution of TAM.

Highlights

  • CANCER MALIGNANCY Ca ncer is a complex multi-step process, in which normal cells acquire a certain growth advantage via a process analogous to Darwinian evolution

  • M-CSF receptor (M-CSFR) signaling blockade was reported to result in preferential depletion of MMRhigh M2-like tumor-associated macrophages (TAM) and reprograming of the phenoptype of the remaining TAM, with alleviated immunosuppressive activities and enhanced antigen presentation capacity and which in turn correlated with enhanced CD4+ and CD8+ T cell responses

  • Phase I clinical trials of anti-M-CSFR monoclonal antibody (mAb) in patients with advanced solid tumors are currently being conducted by Eli Lilly and Company for the fully human IgG1 IMC-CS4 [107] and by Roche for the humanized IgG1 RG7155 [135]

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Summary

Introduction

CANCER MALIGNANCY Ca ncer is a complex multi-step process, in which normal cells acquire a certain growth advantage via a process analogous to Darwinian evolution. In mice bearing transplantable pancreatic ductal adenocarcinomas, the M-CSFR inhibitors GW2580 or PLX3397 were even reported to significantly deplete macrophages expressing high levels of MHCII, but not the more M2-oriented MHC-IIlow or Tie2+ TAM [105].

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