• CAR-M therapy leverages macrophages' natural tumor infiltration and phagocytosis to overcome solid tumor barriers that limit CAR-T efficacy.
• CAR-M remodels the tumor microenvironment by promoting M1 polarization, degrading ECM, and enhancing antigen presentation to activate adaptive immunity.
• Current optimization strategies include 'armored' CAR-Ms to counteract immunosuppression and suicide switches for improved safety.
• CAR-M is advancing to early-phase clinical trials for solid tumors and expanding its potential to non-oncological diseases.