Advances in the Role of FOXM1 and Ferroptosis in the Diagnosis, Treatment, and Prognosis of Hepatocellular Carcinoma

Abstract: Hepatocellular carcinoma (HCC) is a highly lethal cancer with a poor prognosis due to difficulties in early diagnosis. In recent years, the roles of FOXM1 and ferroptosis in HCC have attracted attention. FOXM1, a key transcription factor highly expressed in HCC, is closely associated with tumor progression. Ferroptosis, a form of cell death driven by iron metabolism disorders and lipid peroxidation, is closely related to the occurrence and drug resistance of HCC. Studies have shown that FOXM1 significantly influences ferroptosis by regulating genes associated with iron metabolism and antioxidant defenses (such as SLC7A11 and GPX4) and by affecting signaling pathways, like PI3K/Akt/mTOR. Additionally, the interactions of FOXM1 with factors, such as IDO1 and AURKA/NRF2, also modulate the sensitivity of HCC cells to ferroptosis. This review explores the regulatory relationships between FOXM1 and ferroptosis and their potential value in the diagnosis, treatment, and prognosis of HCC, providing a theoretical basis for the development of new therapeutic strategies.