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It details mechanisms by which TAMs drive tumor progression and immune evasion and discusses opportunities to reprogram TAMs to strengthen anticancer therapies. The synthesis aims to support deeper future research.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/tumor-associated-macrophages-orchestrators-of-cholangiocarcinoma-progression-review/338167/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/tumor-associated-macrophages-orchestrators-of-cholangiocarcinoma-progression-review/338167.png","ImageObject",300,407,{"name":42,"@type":43},"Levi","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are tumor-associated macrophages important in cholangiocarcinoma?","Question",{"text":63,"@type":64},"TAMs show remarkable plasticity in the tumor microenvironment and can promote or suppress tumor development. Their interactions with cancer cells and stromal components critically shape disease progression.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What is the main clinical challenge addressed by this review?",{"text":68,"@type":64},"Advanced cholangiocarcinoma is commonly treated with gemcitabine plus cisplatin, but effectiveness is limited by therapeutic resistance. Many patients are also not eligible for surgery at diagnosis due to late-stage detection.",{"name":70,"@type":61,"acceptedAnswer":71},"How might TAMs be targeted to improve treatment outcomes?",{"text":72,"@type":64},"The review highlights the potential to reprogram TAMs so they shift toward antitumor phenotypes. 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Immunol. 15:1451474 .  \ndoi: 10.3389/fimmu.2024.1451474  \nCOPYRIGHT  \n© 2024 Chen, Sheng, Li, Gao, Hu, Chen, Fei and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nTumor-associated macrophages: orchestrators of cholangiocarcinoma progression  \nFei Chen 1†, Jian Sheng 2†, Xiaoping Li 1†, Zhaofeng Gao 1,  \nLingyu Hu 1, Minjie Chen 1*, Jianguo Fei 1* and Zhengwei Song 1*  \n1 Department of Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China, 2 Department of Research and Teaching, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China  \nCholangiocarcinoma (CCA) is a rare but highly invasive cancer, with its incidence rising in recent years. Currently, surgery remains the most definitive therapeutic option for CCA. However, similar to other malignancies, most CCA patients are not eligible for surgical intervention at the time of diagnosis. The chemotherapeutic regimen of gemcitabine combined with cisplatin is the standard treatment for advanced CCA, but its effectiveness is often hampered by therapeutic resistance. Recent research highlights the remarkable plasticity of tumor-associated macrophages (TAMs) within the tumor microenvironment (TME) . TAMs play a crucial dual role in either promoting or suppressing tumor development, depending on the factors that polarize them toward pro-tumorigenic or antitumorigenic phenotypes, as well as their interactions with cancer cells and otherstromal components. In this review, we critically examine recent studies on TAMs in CCA, detailing the expression patterns and prognostic significance of different TAM subtypes in CCA, the mechanisms by which TAMs influence CCA progression and immune evasion, and the potential for reprogramming TAMs to enhance anticancer therapies. This review aims to provide a framework for deeper future research.  \nKEYWORDS  \nCCA, TAMs, macrophage reprogramming, immune evasion, tumor microenvironment  \n1 Introduction  \nCCA, the second most common primary malignancy of the liver, accounts for 10-15% of hepatic cancers (1, 2). Risk factors for CCA, which vary by location and ethnicity, mainly include hepatic fluorosis, metabolic syndromes like obesity and diabetes, non-alcoholic fatty liver disease, excessive alcohol consumption, and hepatitis B or C virus infections (3– 6) . CCA is traditionally classified into extrahepatic (eCCA) and intrahepatic (iCCA) forms, with eCCA further divided into distal (dCCA) and perihilar (pCCA) subtypes (1) . The subtypes display distinct etiologies, prognoses, and treatment approaches. Surgery remains the cornerstone treatment for CCA (7) . The anatomical locati","cbCaigOw2aSwjS9B","https://ap.wps.com/l/cbCaigOw2aSwjS9B","pdf",1407749,14,"English","# Introduction\n## Cholangiocarcinoma background and standard therapy\n## Role of TAMs in the tumor microenvironment\n# TAM subtypes, prognostic significance, and mechanisms\n## TAM-driven progression and immune evasion\n# Reprogramming TAMs for therapeutic enhancement","[{\"question\":\"Why are tumor-associated macrophages important in cholangiocarcinoma?\",\"answer\":\"TAMs show remarkable plasticity in the tumor microenvironment and can promote or suppress tumor development. Their interactions with cancer cells and stromal components critically shape disease progression.\"},{\"question\":\"What is the main clinical challenge addressed by this review?\",\"answer\":\"Advanced cholangiocarcinoma is commonly treated with gemcitabine plus cisplatin, but effectiveness is limited by therapeutic resistance. Many patients are also not eligible for surgery at diagnosis due to late-stage detection.\"},{\"question\":\"How might TAMs be targeted to improve treatment outcomes?\",\"answer\":\"The review highlights the potential to reprogram TAMs so they shift toward antitumor phenotypes. This could enhance anticancer therapies by reducing immune evasion and improving immune control.\"}]","Tumor-associated macrophages: orchestrators of cholangiocarcinoma progression - review | PDF",1790022320,35]