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@northwell-journals.bsky.socialSep 16, 2026, 6:49 PM

Molecular Medicine - Journal
Article in Press: Metabolism-guided precision oncology in hepatocellular carcinoma: vascular, stromal and immune crosstalk | #MolecularMedicine #HepatocelluarCarcinoma #HCC #Metabolomics link.springer.com/article/10.1...

Fig. 6 Therapeutic strategies targeting metabolic–vascular interactions in HCC. This schematic summarizes therapeutic concepts that arise from metabolism–vascular crosstalk in HCC. The figure is organized into four modules: tumor-intrinsic metabolic targets, endothelial cell metabolism and angiogenesis, stromal and myeloid targeting, and rational combination strategies. Tumor-intrinsic metabolic interventions include inhibition of lactate production, lactate transport, glycolytic enzymes, glutamine metabolism, fatty-acid oxidation, and lactylation-associated signaling. Endothelial-directed strategies include anti-VEGF/VEGFR therapies, PFKFB3 inhibition, and modulation of endothelial barrier function. Stromal and myeloid strategies include TAM repolarization, lactylation-related targeting, TGF-β inhibition, CAF modulation, and periostin blockade. The combination module illustrates how metabolic interventions may be paired with anti-angiogenic therapy or PD-1/PD-L1 blockade to enhance vascular normalization and anti-tumor immunity. Approved anti-angiogenic and immunecheckpoint therapies are shown as established clinical backbones, whereas metabolic, stromal, lactylation-associated, and CAF/TAM-directed strategies should be interpreted as investigational or preclinical candidates for biomarker-enriched testing rather than as established treatment options. Approved agents are shown in solid blue boxes, whereas investigational and preclinical strategies are shown in gray boxes with dashed outlines.