Advances in Liver Oncology: Molecular Mechanisms and Therapeutic Innovations

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1908

Special Issue Editors


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Guest Editor
Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
Interests: liver cancer, hepatocellular carcinoma, cholangiocarcinoma, liver metastases, tumor microenvironment, targeted therapy, immunotherapy, biomarkers, drug resistance

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Guest Editor
1. Surgery Department, Unidade Local de Saude de Coimbra, Coimbra, Portugal
2. Faculdade de Medicina, Universidade de Coimbra, Portugal
3. ACIMAGO, Coimbra, Portugal
4. Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Interests: animal models of disease; liver transplant pathology; colorectal cancer; liver metastases; GI cancer; surgery
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Special Issue Information

Dear Colleagues,

Liver cancer is among the highest hurdles in oncology. It includes hepatocellular carcinoma (HCC), cholangiocarcinoma, and metastasis in the liver. Even though enormous progress has been made in their diagnosis and treatment, these cancers remain great challenges since their biology is complex, they are often diagnosed at an advanced stage, and they do not respond to the standard therapies. The TME is a critical component in the evolution of liver cancers and metastases, dictating the fate of cancer cells by regulating survival, immune evasion, and therapeutic resistance.

This special issue aspires to encompass the general outlook on recent updates of research in liver oncology, whether primary liver cancers or liver metastases. We would like to bring out the molecular mechanisms behind such diseases and present novel therapeutic strategies that may be devised to interfere with these processes.

We welcome the submission of peer-reviewed original research, reviews, and communications dedicated to the following topics of basic science and translational research in liver oncology, but not limited to:

  • Molecular signaling involved in hepatocarcinogenesis and its potential therapeutic implications;
  • The role of the tumor microenvironment in progression to liver cancer and treatment response;
  • Molecular cross-talk between liver stromal cells and metastatic cancer cells;
  • The contribution of immune-microenvironment to liver metastatic progression and therapy resistance;
  • Genetic and epigenetic alterations in liver cancer and their implications for targeted therapy;
  • Effects of extracellular matrix remodeling on the initiation and progression of liver metastasis;
  • Recent advances in immunotherapy and their applicability for both primary liver cancers and liver metastases;
  • The rationales and experimental strategies for biomarker discovery in liver cancers and metastases in early detection, prognostics, and therapeutic response;
  • Recent advances in molecular liver oncology with respect to new drug delivery systems and combination therapies.
  • Innovative treatment centered on the heterogeneous cells of the TME in liver metastases: immunotherapy strategies and approaches to stroma derivatives and the TME matrix.

Prof. Dr. Rui Caetano Oliveira
Dr. Rui Miguel Martins
Prof. Dr. José Guilherme Tralhão
Guest Editors

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Keywords

  • liver cancer
  • hepatocellular carcinoma
  • cholangiocarcinoma
  • liver metastases
  • tumor microenvironment
  • targeted therapy
  • immunotherapy
  • biomarkers
  • drug resistance

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Published Papers (3 papers)

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Research

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16 pages, 1491 KiB  
Article
Targeting iNAMPT and NAD Biosynthesis to Break the Obesity-Associated Liver Cancer Link
by Kelly Thornton, Linda Torres, Elisa L. Pedone, Jessica S. Waltenbaugh, Cassandra M. Swanson, Emily Gonzalez and Ramona S. Price
Biomedicines 2025, 13(7), 1533; https://doi.org/10.3390/biomedicines13071533 - 24 Jun 2025
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Abstract
Background and Objectives: Obesity is linked to liver cancer through metabolic mechanisms and can promote tumor growth through metabolic impairment, decreased lipid metabolism, and interference of the energy balance in the liver. NAMPT is an enzyme expressed in the liver and is involved [...] Read more.
Background and Objectives: Obesity is linked to liver cancer through metabolic mechanisms and can promote tumor growth through metabolic impairment, decreased lipid metabolism, and interference of the energy balance in the liver. NAMPT is an enzyme expressed in the liver and is involved in the progression of tumors in obesogenic environments, while iNAMPT is known to be the rate-limiting enzyme in the synthesis of NAD, an essential coenzyme involved in ATP synthesis which promotes a pro-growth environment in the context of obesity. Because iNAMPT and cellular energetics, a hallmark of cancer, play an important role in liver cancer progression, it has become a target for cancer therapies focused on inhibiting its functions. The objective of this study was to determine the contribution of NAD biosynthesis in obesity-associated liver cancer progression. Methods: Cell culture studies were conducted with serum from male mice randomized to diet-induced obesity (OB) or control (CR) ± FK866 (iNAMPT inhibitor) in SNU, HepG2 human liver cancer cells, and Hepa 1-6 liver murine cells. Protein analysis of pAkt and pErk was performed via immunoblot. Cytotoxicity, reactive oxygen species (ROS), cell viability, and invasion were also measured in the cells. For the mouse model, the C57BL/6J male mice were randomized to the DIO or CR group. At 21 weeks of age, the mice were injected subcutaneously with Hepa 1-6 liver cancer cells. At 23 weeks, the mice received an I.P. injection of FK866 (30 mg/kg) for 2 weeks. The tumor and mouse weights were measured. Results: The cells exposed to OB sera showed increased proliferation, lactate dehydrogenase (LDH) secretion, ROS, and invasion. FK866 decreased proliferation, LDH secretion, ROS, and invasion for all liver cancer cells. The cells exposed to CR sera and OB + FK866 resulted in more LDH, suggesting increased apoptosis compared with OB sera. The OB sera increased phosphorylation of Akt, which was suppressed by FK866 compared with the OB group. In liver cancer cells, physiological and cellular signaling is affected differently when inhibiting NAD biosynthesis in an in vitro model of obesity and liver cancer. In vivo, the diet-induced obese (DIO) mice weighed significantly more than the mice fed a control diet. In addition, 70% of the DIO mice developed tumors, compared with 20% of the CR mice, and had tumors with greater volumes and weights. NAD inhibition blocked obesity-induced tumor growth. Conclusions: In this study, we demonstrate that inhibition of iNAMPT resulted in suppression of tumor growth in the context of obesity. Identifying pre-clinical strategies to reverse the impact of obesity on liver cancer progression is important due to the strong increased risk of liver cancer and its poor prognosis. Future translational research studies can be built from this pre-clinical foundational research. Full article
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Review

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19 pages, 588 KiB  
Review
Targeting Glypican-3 in Liver Cancer: Groundbreaking Preclinical and Clinical Insights
by Luca Filippi, Viviana Frantellizzi, Luca Urso, Giuseppe De Vincentis and Nicoletta Urbano
Biomedicines 2025, 13(7), 1570; https://doi.org/10.3390/biomedicines13071570 - 26 Jun 2025
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Abstract
Positron emission tomography (PET) imaging targeting glypican-3 (GPC3) holds promise for improving the detection and characterization of hepatocellular carcinoma (HCC). Preclinical and early clinical studies have largely utilized high-molecular-weight antibodies radiolabeled with isotopes such as 89Zr and 124I, demonstrating high affinity [...] Read more.
Positron emission tomography (PET) imaging targeting glypican-3 (GPC3) holds promise for improving the detection and characterization of hepatocellular carcinoma (HCC). Preclinical and early clinical studies have largely utilized high-molecular-weight antibodies radiolabeled with isotopes such as 89Zr and 124I, demonstrating high affinity and tumor uptake but suffering from prolonged circulation times and suboptimal signal-to-background ratios. To address these limitations, interest has shifted toward low-molecular-weight vectors—synthetic peptides and small antibody fragments—labeled with shorter-lived radionuclides (e.g., 68Ga and 18F) to enable rapid pharmacokinetics and same-day imaging protocols. Emerging platforms such as affibodies and aptamers offer further advantages in target affinity and reduced immunogenicity. However, clinical translation requires rigorous validation: larger, histologically confirmed cohorts, head-to-head comparison with CT/MRI, and correlation with hard clinical endpoints. Moreover, leveraging GPC3 expression as a biomarker could guarantee a deeper knowledge of tumor biology—differentiation grade and vascular invasion risk—and guide theranostic strategies. While β-emitters (90Y, 177Lu) have been explored for GPC3-directed therapy, their efficacy is influenced by oxygenation and cell-cycle status, whereas α-emitters (225Ac) may overcome these constraints, albeit with challenges in radionuclide selection and daughter nuclide management. Finally, dual-targeting probes combining GPC3 and prostate-specific membrane antigen (PSMA) have demonstrated superior uptake and retention in murine models, suggesting a versatile approach for future clinical diagnostics and therapy planning. Full article
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Other

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11 pages, 596 KiB  
Systematic Review
Novel Biomarkers in Hepatocellular Carcinoma from Embryogenic Antigens to cfDNA
by Robeer Ghantus, Răzvan Alexandru Ciocan, Diana Schlanger, Călin Popa, Claudia Diana Gherman, Călin Vaida, Bogdan Gherman, Doina Pîslă, Nadim Al Hajjar and Andra Ciocan
Biomedicines 2025, 13(5), 1020; https://doi.org/10.3390/biomedicines13051020 - 23 Apr 2025
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Abstract
Background: Hepatocellular carcinoma (HCC), a primary liver cancer, continues to pose a significant challenge to the healthcare system because of its elevated incidence and fatality rates. This study aims to assess new biomarkers for early diagnosis and prognosis, comparing them to the established [...] Read more.
Background: Hepatocellular carcinoma (HCC), a primary liver cancer, continues to pose a significant challenge to the healthcare system because of its elevated incidence and fatality rates. This study aims to assess new biomarkers for early diagnosis and prognosis, comparing them to the established gold standard alpha-fetoprotein (AFP) and liver ultrasonography. Methods: A literature review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline. A total of 670 papers were identified using internet databases. After applying the exclusion criteria, eight studies were included in this literature review. Results: It was identified that certain analyzed biomarkers, or the combinations thereof, exhibited superior sensitivity compared to the existing gold standard. The circulating cell-free DNA (cfDNA) and microRNAs (miRNAs), proved to have encouraging outcomes, particularly for the early identification of HCC. Additional indicators, such as circulating tumor cells (CTCs) and the alkaline phosphatase plus gamma-glutamyl transpeptidase to lymphocyte ratio (AGLR), may forecast disease progression, particularly regarding vascular invasion. Conclusions: These biomarkers may assist clinicians in making better therapeutical choices in order to provide personalized treatment and optimal follow-up for HCC patients. Full article
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