Role of Colony Stimulating Factor 1 (CSF-1) and Its Receptor CSF1R: Macrophage Repolarization for Glioblastoma Treatment

Glioblastoma multiforme (GBM) is the most aggressive and prevailing form of primary brain tumor, illustrated by its rapid growth and invasive nature. GBM continues to be highly incurable despite advancements in treatment due to its complex tumor microenvironment (TME) and the unique characteristics of tumor-associated macrophages (TAMs). This review explores the function of macrophages within the TME of GBM, specifically emphasizing the impact of colony-stimulating Factor-1 (CSF-1) and its receptor CSF1R in macrophage biology. The progression, survival, and differentiation of TAMs, which often rely on immunosuppressive properties that contribute to tumor growth and treatment resistance, are facilitated by elevated CSF-1 levels in GBM. The inhibition of CSF1R presents a promising therapeutic strategy, as it selectively targets tumor-promoting macrophages while sparing antitumor macrophages. Preclinical evidence demonstrates improved survival outcomes through CSF1R inhibition in mouse models, highlighting its potential for clinical application. Ongoing clinical trials further investigate this approach, aiming to enhance treatment efficacy for patients with GBM. This review concludes by emphasizing the significance of repolarizing macrophages as a novel therapeutic opportunity in GBM management, alongside emerging trends and future research directions that could lead to breakthroughs in treatment strategies.