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REVIEW

Navigating the Tumor Microenvironment in Colorectal Liver Metastasis: Barriers to Therapy and Emerging Opportunities

Pengtao Hu1, Junjie Sun1, Jian Lu2, Chunlei Ge3, Hanzhi Sun1, Chengyu Lv1,*
1 Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
2 International Oncology Institute, the First Affiliated Hospital of Zhejiang Chinese Medical University, Oncology Department of the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
3 Department of General Surgery, Gaochun Hospital of Traditional Chinese Medicine, Nanjing, China
* Corresponding Author: Chengyu Lv. Email: email
(This article belongs to the Special Issue: Advances and Innovations in Colorectal Cancer Research and Treatment)

Oncology Research https://doi.org/10.32604/or.2026.076013

Received 12 November 2025; Accepted 20 February 2026; Published online 18 March 2026

Abstract

Liver metastases from colorectal cancer (CRC) are a primary cause of poor patient prognosis, closely linked to the liver’s unique tumor microenvironment (TME). Compared to primary tumors, research on the TME of liver metastases remains insufficient. This review systematically summarizes recent advances in TME research concerning colorectal liver metastases (CRLM), emphasizing its organ-specific characteristics, pivotal role in tumor progression, and influence on treatment response. We delve into the intricate cellular components of the TME—including tumor-associated macrophages, cancer-associated fibroblasts, and myeloid-derived suppressor cells—and non-cellular constituents such as the extracellular matrix and soluble factors. Furthermore, we explore the multifaceted mechanisms which the TME drives CRLM progression through establishing pre-metastatic niches, facilitating cancer cell colonization, mediating immune evasion, and inducing drug resistance. Additionally, we evaluate therapeutic strategies targeting the TME, including opportunities and challenges in remodeling cellular components, modulating the extracellular matrix, and developing combination therapies. Ultimately, this review aims to provide theoretical foundations and novel insights for developing more effective anti-metastatic therapies, with the goal of improving the prognosis for CRLM patients.

Keywords

Colorectal cancer; liver metastasis; tumor microenvironment; pre-metastatic niche; immuno-suppression; targeted therapy

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