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In this context, PCa initially shows a favorable response to immunotherapy. However, as the disease progresses, the tumor gradually develops resistance to immunotherapy, with tumor\u2010associated macrophages (TAMs) being key drivers. TAMs promote inflammation, angiogenesis, stromal remodeling, and immune evasion, leading to the development of castration\u2010resistant PCa. The traditional M1\/M2 dichotomy, such as proliferative\u2010TAM (Prolif\u2010TAM) and immunoregulatory\u2010TAM (Reg\u2010TAM), has been refined by single\u2010cell RNA sequencing. In this article, we further discuss how signaling pathways regulate TAM polarization and investigate the multidimensional mechanisms by which TAMs drive PCa progression, the pathways that promote immunotherapy resistance, and the role of macrophage extracellular traps (METs) in PCa metastasis. Targeting TAMs for precision treatment of PCa is a promising therapeutic strategy. These strategies include blocking the adenosine pathway to inhibit SPP1\n                    <jats:sup>hi<\/jats:sup>\n                    \u2010TAMs, reprogramming TAMs with immune checkpoint inhibitors (ICIs) to restore chimeric antigen receptor (CAR)\u2010T cell activity, and novel approaches such as using microRNAs (miRNAs) and natural compounds to modulate TAM polarization. However, these treatment modalities still face challenges, including the complexity of the tumor microenvironment (TME) and TAM heterogeneity, obstacles in drug production and delivery, and toxicity management. This article aims to develop individualized targeting strategies based on the composition, functional status, and signaling dependencies of TAM subpopulations within patient tumors, with the hope of transitioning from a \u201cone\u2010size\u2010fits\u2010all\u201d approach to precision medicine.\n                  <\/jats:p>","DOI":"10.1155\/jimr\/6287638","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:30:08Z","timestamp":1780637408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Research Progress of Tumor\u2010Associated Macrophages in Prostate 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