CELL INTELLIGENCE · 肿瘤细胞治疗研究

Osteosarcoma (OS), the most common primary malignant bone tumor, poses significant clinical challenges owing to its high metastatic potential and resistance to chemotherapy. Although Chimeric Antigen Receptor T-Cell Immunotherapy (CAR-T) has made significant progress in treating hematologic malignancies, its efficacy remains limited in solid tumors, such as OS. Chimeric antigen receptor macrophages (CAR-M ) represent an emerging cell therapy. It possesses potent phagocytic killing capabilities and inherent immune-modulatory properties. It has the unique potential to reshape the immunosuppressive microenvironment of OS. This review systematically outlines the target selection of CAR-M in OS, its dual mechanisms of direct killing and indirect immune modulation, and thoroughly explores strategies to overcome tumor heterogeneity and immune suppression using CAR-M approaches. Finally, it highlights the current challenges and future development directions. This emphasizes that CAR-M therapy holds promise as a key breakthrough in overcoming the treatment bottleneck for OS. It is a key driver of the shift in the therapeutic paradigm from targeting cell toxicity to reshaping the immune microenvironment.