This relationship is biologically plausible as TAMs have been shown to promote matrix remodeling through the secretion of enzymes such as matrix metalloproteinase-9 (MMP-9) and lysyl oxidase (LOX), both of which contribute to collagen degradation, cross-linking, and fiber shortening [57,71] Conversely, changes in the physical properties of the ECM—including increased stiffness and altered fiber orientation—can activate integrin-dependent signaling pathways that attract and polarize macrophages toward an M2-like tumor-promoting phenotype [42,45,72]. Here, MMP9 is linked to neoplasm.