Liver cancer

Clinical / Scientific

Primary liver cancers are mainly hepatocellular carcinoma and intrahepatic cholangiocarcinoma, with distinct cell of origin, Wnt versus FGFR/IDH maps, and shared inflammatory-fibrotic niches.

Core Biological Drivers

Cirrhotic / cholestatic niche

Shared injury context.

HCC vs CCA oncogenes

Wnt/TERT versus FGFR/IDH/KRAS.

Key Pathways

Wnt/β-catenin

Scientific explanation

Canonical Wnt signalling stabilizes β-catenin, driving TCF/LEF . APC loss is a classic colorectal initiating event; the pathway also contributes to stemness in several tissues.

VEGF

Scientific explanation

family ligands drive endothelial sprouting and vascular permeability, a canonical tumour axis.

TGF-β

Scientific explanation

TGF-β is cytostatic in intact epithelium but later supports , immune suppression and stromal . Context switches its role during progression.

NF-κB

Scientific explanation

NF-κB factors link inflammatory cytokines and innate sensors to survival, production and sometimes therapy resistance.

Glycolysis

Scientific explanation

Aerobic (Warburg metabolism) supports ATP, biomass and redox buffering even when oxygen is available. Hexokinase, PKM2 and lactate export are frequent nodes.

PD-1 / PD-L1

Scientific explanation

PD-1 on T cells engaging PD-L1/PD-L2 restrains cytotoxic function. Tumour or myeloid PD-L1 is a canonical adaptive immune-evasion axis.

Pathway Convergence

Target → pathway → downstream effect → biological consequence. Shared intersections are mechanistic maps, not protocols.

Hypoxia to vessels

Low oxygen stabilizes HIF-1α, inducing VEGF and endothelial sprouting. Anti-angiogenic pharmacology intersects this axis but does not erase the tumour ecosystem.

Hypoxia
↓
HIF-1α
↓
VEGF
↓
Angiogenesis

Inflammatory survival

Chronic cytokine tone activates NF-κB and STAT3 transcriptional programmes that favour survival, invasion and sometimes immune evasion.

Cytokines
↓
NF-κB / STAT3
↓
Survival and invasion genes
↓
Therapy-tolerant phenotype

Metabolic Vulnerabilities

Aerobic supports ATP, biomass and acidification even when oxygen is available. Extent varies by tumour and remains a vulnerability hypothesis rather than a uniform target.

Tumor Microenvironment

Cancer-associated fibroblasts, TGF-β and extracellular-matrix stiffness can compress vessels and exclude T cells, especially in desmoplastic tumours.

Disordered vasculature creates , HIF-1α stabilization, induction and immune-suppressive adenosine/lactate milieus.

Metastasis Module

, protease-mediated invasion, , circulating tumour-cell survival and organ-specific colonization form the metastatic cascade. Pre-metastatic niches and vascular permeability influence tropism.

Resistance Biology

Resistance can arise from drug efflux, secondary mutations, bypass RTK signalling, apoptotic threshold elevation, -mediated survival, metabolic adaptation and lineage plasticity.

Cancer Stemness

Wnt, Notch, Hedgehog, ALDH and CD44-associated programmes can mark stem-like fractions with quiescence and therapy tolerance. These markers are not interchangeable across tumour types.

Mechanism-Based Adjunctive Strategies

Compounds appear only where a mechanistic overlap exists for this cancer. Evidence tiers are not equivalent. Nothing here is a treatment recommendation.

Metformin

Clinical / Human EvidenceIn VivoIn VitroMechanistically Plausible

Target / Mechanism

Modest complex I inhibition raises AMP:ATP, activating and restraining hepatic and -linked anabolism. Direct antineoplastic efficacy is not established from that pharmacology alone.

Cancer relevance

activation and restraint provide a metabolic rationale in - and -linked tumours. Human data are mixed and do not establish metformin as cancer therapy.

Metabolic adjunctive research context. Convergence: AMPK, mTOR, Glycolysis.

Curcumin

In VitroMechanistically Plausible

Target / Mechanism

Polyphenol with promiscuous in-vitro NF-κB, and ROS effects. Bioavailability is poor; dish activity does not establish clinical anticancer efficacy.

Cancer relevance

In-vitro NF-κB/ effects are frequent. Poor bioavailability and absence of robust clinical anticancer efficacy keep this pathway-level.

Inflammatory-signalling dish models. Convergence: NF-κB, JAK/STAT.

Research Context

  1. HCC. Llovet JM, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2021;7(1):6. https://doi.org/10.1038/s41572-020-00240-3
  2. Hallmarks. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-674. https://doi.org/10.1016/j.cell.2011.02.013

This oncology atlas is educational. Pathway maps, adjunctive strategies, and compound listings describe mechanistic relevance. They do not establish clinical efficacy, do not recommend treatment, and are not a substitute for oncology care. Evidence tiers are not equivalent.