Engineering macrophages for cancer immunotherapy: emerging insights and therapeutic potential

Abstract Macrophages strongly influence cancer progression through their adaptable phenotypes and responses to mechanical and biochemical cues. Their abundance across tumors and links to poor outcomes drive interest in macrophage-targeted therapies. This review highlights macrophage mechanobiology, key behaviors, and the potential of engineered macrophages, using genetic (CAR) or non-genetic “Trojan horse” and “backpacking” strategies, to deliver therapies and reshape the immunosuppressive tumor microenvironment.