肿瘤免疫微环境（TIME）会限制传统癌症疗法的有效性并常常导致显着的副作用。因此，人们越来越有兴趣确定新的靶点以提高癌症靶向治疗的功效。更多研究表明，肿瘤相关巨噬细胞（TAM）源自骨髓祖细胞产生的外周血单核细胞，在肿瘤微环境（TME）中发挥着至关重要的作用，并与传统癌症治疗的耐药性密切相关。脂质代谢的改变已被广泛认为对肿瘤及其免疫微环境具有重大影响。脂质、脂质衍生物及其代谢途径中的关键物质可以通过调节TAM的表型、功能和活性来影响癌细胞的癌变和进展。因此，本综述重点关注癌细胞中脂质代谢的重编程及其免疫微环境，其中TAM尤其集中。这些变化会影响 TAM 的激活和极化，从而影响肿瘤细胞对治疗的反应。此外，本文还探讨了靶向 TAM 脂质代谢作为传统癌症治疗的补充方法的潜力。它回顾和评估了当前通过 TAM 脂质代谢增强疗效的策略，并提出了新的脂质代谢靶点作为放化疗和免疫治疗的潜在协​​同选择。这些努力旨在促进该领域的进一步研究。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

The tumor immune microenvironment (TIME) can limit the effectiveness and often leads to significant side effects of conventional cancer therapies. Consequently, there is a growing interest in identifying novel targets to enhance the efficacy of targeted cancer therapy. More research indicates that tumor-associated macrophages (TAMs), originating from peripheral blood monocytes generated from bone marrow myeloid progenitor cells, play a crucial role in the tumor microenvironment (TME) and are closely associated with resistance to traditional cancer therapies. Lipid metabolism alterations have been widely recognized as having a significant impact on tumors and their immune microenvironment. Lipids, lipid derivatives, and key substances in their metabolic pathways can influence the carcinogenesis and progression of cancer cells by modulating the phenotype, function, and activity of TAMs. Therefore, this review focuses on the reprogramming of lipid metabolism in cancer cells and their immune microenvironment, in which the TAMs are especially concentrated. Such changes impact TAMs activation and polarization, thereby affecting the tumor cell response to treatment. Furthermore, the article explores the potential of targeting the lipid metabolism of TAMs as a supplementary approach to conventional cancer therapies. It reviews and evaluates current strategies for enhancing efficacy through TAMs' lipid metabolism and proposes new lipid metabolism targets as potential synergistic options for chemo-radiotherapy and immunotherapy. These efforts aim to stimulate further research in this area.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.