Metabolic reprogramming and the tumor microenvironment in hepatocellular carcinoma: mechanisms and therapeutic targeting
Zhao Ruan , Xuedan Sun
Hepatoma Research ›› 2026, Vol. 12 -9.
Metabolic reprogramming is a fundamental mechanism through which tumor cells reshape their energy metabolism to sustain rapid proliferation. It facilitates malignant growth by reprogramming key pathways, including glycolysis and amino acid metabolism. The tumor microenvironment (TME) is composed of tumor cells, stromal cells, and immune cells. The characteristics of hypoxia, acidity, and nutrient deficiency are mainly driven by the metabolic products and cytokines secreted by tumor cells. This metabolic pressure not only inhibits the functions of immune cells, but also further enhances immune evasion through nutrient competition. Targeting metabolic reprogramming can reverse immunosuppression within the TME and enhance the response to immunotherapy. This article systematically reviews the regulatory mechanisms of metabolic reprogramming in hepatocellular carcinoma and its impact on the TME, while also exploring therapeutic strategies based on metabolic interventions.
Metabolic reprogramming / tumor microenvironment / hepatocellular carcinoma / targeted therapy / immunotherapy
| [1] |
|
| [2] |
Allemani C, Matsuda T, Di Carlo V, et al.; CONCORD Working Group. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries.Lancet2018;391:1023-75 PMCID:PMC5879496 |
| [3] |
|
| [4] |
|
| [5] |
|
| [6] |
Al Noshokaty T, Mesbah N, Abo-Elmatty D, Abulsoud A, Abdel-Hamed A. Hepatocellular carcinoma pathogenesis: epigenetics and relationship with cancer hallmarks.Rec Pharm Biomed Sci2022;6:136-57 |
| [7] |
|
| [8] |
|
| [9] |
|
| [10] |
|
| [11] |
|
| [12] |
|
| [13] |
|
| [14] |
|
| [15] |
|
| [16] |
|
| [17] |
|
| [18] |
|
| [19] |
|
| [20] |
|
| [21] |
|
| [22] |
|
| [23] |
|
| [24] |
|
| [25] |
|
| [26] |
|
| [27] |
|
| [28] |
|
| [29] |
|
| [30] |
|
| [31] |
|
| [32] |
|
| [33] |
|
| [34] |
|
| [35] |
|
| [36] |
|
| [37] |
|
| [38] |
|
| [39] |
|
| [40] |
|
| [41] |
|
| [42] |
|
| [43] |
Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation.Science2009;324:1029-33 PMCID:PMC2849637 |
| [44] |
|
| [45] |
|
| [46] |
|
| [47] |
|
| [48] |
|
| [49] |
|
| [50] |
|
| [51] |
|
| [52] |
|
| [53] |
|
| [54] |
|
| [55] |
|
| [56] |
|
| [57] |
|
| [58] |
|
| [59] |
|
| [60] |
|
| [61] |
|
| [62] |
|
| [63] |
|
| [64] |
|
| [65] |
|
| [66] |
|
| [67] |
|
| [68] |
|
| [69] |
Currie E, Schulze A, Zechner R, Walther TC, Farese RV Jr. Cellular fatty acid metabolism and cancer.Cell Metab2013;18:153-61 PMCID:PMC3742569 |
| [70] |
|
| [71] |
|
| [72] |
|
| [73] |
|
| [74] |
|
| [75] |
|
| [76] |
|
| [77] |
|
| [78] |
|
| [79] |
|
| [80] |
|
| [81] |
|
| [82] |
|
| [83] |
|
| [84] |
|
| [85] |
|
| [86] |
|
| [87] |
Christofk HR, Vander Heiden MG, Harris MH, et al. The M2 splice isoform of pyruvate kinase is important for cancer metabolism and tumour growth. Nature. 2008;452:230-3. |
| [88] |
Colegio OR, Chu NQ, Szabo AL, et al. Functional polarization of tumour-associated macrophages by tumour-derived lactic acid. Nature. 2014;513:559-63. |
| [89] |
|
| [90] |
|
| [91] |
Sen N, Hara MR, Kornberg MD, et al. Nitric oxide-induced nuclear GAPDH activates p300/CBP and mediates apoptosis. Nat Cell Biol. 2008;10:866-73. |
| [92] |
Hon KW, Naidu R. Unveiling metabolic signatures as potential biomarkers in common cancers: insights from lung, breast, colorectal, liver, and gastric tumours. Biomolecules. 2025;15:1376. |
| [93] |
Yalcin A, Clem BF, Imbert-Fernandez Y, et al. 6-Phosphofructo-2-kinase (PFKFB3) promotes cell cycle progression and suppresses apoptosis via Cdk1-mediated phosphorylation of p27. Cell Death Dis. 2014;5:e1337. |
| [94] |
De Los Santos-Jiménez J, Campos-Sandoval JA, Alonso FJ, Márquez J, Matés JM. GLS and GLS2 glutaminase isoenzymes in the antioxidant system of cancer cells. Antioxidants. 2024;13:745. |
| [95] |
|
| [96] |
Hao Y, Yi Q, XiaoWu X, WeiBo C, GuangChen Z, XueMin C. Acetyl-CoA: an interplay between metabolism and epigenetics in cancer. Front Mol Med. 2022;2:1044585. |
| [97] |
Lopes C, Pereira C, Medeiros R. ASCT2 and LAT1 contribution to the hallmarks of cancer: from a molecular perspective to clinical translation. Cancers. 2021;13:203. |
| [98] |
|
| [99] |
|
| [100] |
Dang L, White DW, Gross S, et al. Cancer-associated IDH1 mutations produce 2-hydroxyglutarate. Nature. 2009;462:739-44. |
| [101] |
Nicklin P, Bergman P, Zhang B, et al. Bidirectional transport of amino acids regulates mTOR and autophagy. Cell. 2009;136:521-34. |
| [102] |
|
| [103] |
|
| [104] |
Altman BJ, Stine ZE, Dang CV. From Krebs to clinic: glutamine metabolism to cancer therapy. Nat Rev Cancer. 2016;16:619-34. |
| [105] |
Spinelli JB, Yoon H, Ringel AE, Jeanfavre S, Clish CB, Haigis MC. Metabolic recycling of ammonia via glutamate dehydrogenase supports breast cancer biomass. Science. 2017;358:941-46. |
| [106] |
|
| [107] |
|
| [108] |
|
| [109] |
Zhang H, Chen H, Yin S, et al. Docosahexaenoic acid reverses PD-L1-mediated immune suppression by accelerating its ubiquitin-proteasome degradation. J Nutr Biochem. 2023;112:109186. |
| [110] |
Chen G, Bao B, Cheng Y, et al. Acetyl-CoA metabolism as a therapeutic target for cancer. Biomed Pharmacother. 2023;168:115741. |
| [111] |
|
| [112] |
Yu X, Wu H, Su J, et al. Acetyl-CoA metabolism maintains histone acetylation for syncytialization of human placental trophoblast stem cells. Cell Stem Cell. 2024;31:1280-97.e7. |
| [113] |
|
| [114] |
Snaebjornsson MT, Janaki-Raman S, Schulze A. Greasing the wheels of the cancer machine: the role of lipid metabolism in cancer. Cell Metab. 2020;31:62-76. |
| [115] |
Bian X, Liu R, Meng Y, Xing D, Xu D, Lu Z. Lipid metabolism and cancer. J Exp Med. 2021;218:e20201606. |
| [116] |
Chen XF, Tian MX, Sun RQ, et al. SIRT5 inhibits peroxisomal ACOX1 to prevent oxidative damage and is downregulated in liver cancer. EMBO Rep. 2018;19:e45124. |
| [117] |
Ding X, Shao L, Wang J, Jin Y, Chen H, Li B. HADHA promotes esophageal cancer progression by activating mTOR signaling and the SP1/MDM2 axis. Acta Biochim Biophys Sin. 2024;57:378-88. |
| [118] |
|
| [119] |
|
| [120] |
|
| [121] |
|
| [122] |
|
| [123] |
|
| [124] |
|
| [125] |
|
| [126] |
|
| [127] |
|
| [128] |
|
| [129] |
|
| [130] |
|
| [131] |
|
| [132] |
|
| [133] |
|
| [134] |
|
| [135] |
|
| [136] |
Chang CH, Curtis JD, Maggi LB Jr, et al. Posttranscriptional control of T cell effector function by aerobic glycolysis.Cell2013;153:1239-51 PMCID:PMC3804311 |
| [137] |
|
| [138] |
|
| [139] |
|
| [140] |
|
| [141] |
|
| [142] |
|
| [143] |
|
| [144] |
|
| [145] |
|
| [146] |
|
| [147] |
|
| [148] |
|
| [149] |
|
| [150] |
|
| [151] |
|
| [152] |
|
| [153] |
|
| [154] |
|
| [155] |
Jin H, Wu P, Lv C, et al. Mannose inhibits PKM2 lactylation to induce pyroptosis in bladder cancer and activate antitumor immune responses. Commun Biol. 2025;8:689. |
| [156] |
|
| [157] |
|
| [158] |
|
| [159] |
|
| [160] |
|
| [161] |
|
| [162] |
|
| [163] |
|
| [164] |
|
| [165] |
|
| [166] |
|
| [167] |
|
| [168] |
|
| [169] |
|
| [170] |
|
| [171] |
|
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