Metastatic hepatic carcinoma: Mechanisms, emerging therapeutics, and future perspectives

Metastatic hepatic carcinoma (MHC) remains a lethal disease, with a 5-year survival rate of around 14%. Although early-stage MHC can be managed through surgery, with or without adjuvant chemotherapy, it remains ultimately incurable due to the presence of disseminated cancer cells, including metastasis-competent cells that are resistant to therapy. Recent research has focused on uncovering the molecular mechanisms driving MHC and addressing the limitations of current treatment strategies. This review highlights newly discovered factors involved in the dissemination of liver cancer cells and their colonization of distant organs, such as genetic mutations, metastasis-initiating cells, epithelial-mesenchymal transition, and the tumor microenvironment. Furthermore, recent advances in precision medicine, genomic profiling, and immunotherapy have made notable strides in improving the treatment landscape for MHC. Thus, we review the state of emerging therapies and outlines future directions for more precise and effective treatment strategies in MHC, such as precision medicine, immunotherapy, bacterial therapy, nanotechnology, and artificial intelligence, offering promising directions for future clinical management of MHC.