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REVIEW article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

This article is part of the Research TopicPrecision Therapeutics in Rare Cancers: Targeting Tumor Microenvironment and Biomarker-Driven ApproachesView all 8 articles

SPP1+ macrophages in tumor immunosuppression: mechanisms and therapeutic implications

Provisionally accepted
Rongcun  YangRongcun Yang1*Juan  Juan WangJuan Juan Wang1Ya  WangYa Wang1,2Yuqing  LiuYuqing Liu1
  • 1Nankai University, Tianjin, China
  • 2Tianjin University of Commerce, Tianjin, China

The final, formatted version of the article will be published soon.

Abstract Secreted phosphoprotein 1 (SPP1⁺) macrophages are a recurrent and functionally critical immune cell subset across multiple cancer types. They drive adverse clinical outcomes by promoting immunosuppression, tumor invasion, metastasis, and therapy resistance. Given their prevalence and pivotal role, SPP1⁺ macrophages have become a major focus in cancer immunology and a promising target for therapeutic development. SPP1⁺ macrophages have been identified in a wide range of human malignancies through single-cell RNA sequencing and spatial transcriptomics studies. Their differentiation and maintenance are strongly influenced by reciprocal cellular interactions and hypoxic conditions within the tumor microenvironment (TME). Within the tumor microenvironment (TME), SPP1⁺ macrophages promote tumor progression by interacting with cancer-associated fibroblasts (CAFs) and helping to form a physical barrier that restricts immune cell infiltration into the tumor core. Specifically, they impair the recruitment of CD8⁺ T cells and promote T cell exhaustion (TEX). In this review, we focus on recent advances in understanding the differentiation of SPP1 macrophages in hypoxic tumor microenvironment and the role of SPP1⁺ macrophages in immunosuppression and their therapeutic implications in cancer. Targeting this subset of macrophages has emerged as a highly promising therapeutic strategy, with several approaches demonstrating encouraging results in preclinical models.

Keywords: SPP1+ macrophages, t cell exhaustion, Physical barrier, Osteopontin, cancer therapy

Received: 23 Sep 2025; Accepted: 24 Nov 2025.

Copyright: © 2025 Yang, Wang, Wang and Liu. 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) or licensor 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.

* Correspondence: Rongcun Yang

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