Harnessing macrophages for precision drug delivery and cancer therapy: Strategies, advances and challenges

Macrophages possess inherent tumor tropism, the capacity to traverse biological barriers, and potent immunomodulatory activity, positioning them as living carriers for precision drug delivery in cancer therapy. By leveraging these properties, macrophage-based drug delivery systems mitigate persistent limitations of conventional modalities, including poor intratumoral penetration, off-target toxicity, and rapid systemic clearance. This review highlights the unique capabilities of macrophages in drug delivery, discussing their sources, preparation, and engineering strategies for enhanced therapeutic efficacy. Key advancements in drug loading methods and applications in cancer treatment are also discussed. Despite these advancements, macrophage-based systems face challenges such as immune compatibility, large-scale production, and precise control of drug release. We conclude by outlining future opportunities to harness macrophages for precision medicine, emphasizing their transformative potential in improving cancer therapy outcomes.