BMJ Gut February 2026:Galectin-4 drives anti-PD-L1/BVZ resistance by regulating metabolic adaptation and tumour-associated neutrophils in hepatocellular carcinoma

This research investigates why most liver cancer patients fail to respond to standard combined immunotherapy, identifying a protein called galectin-4as a primary culprit behind treatment resistance. By stabilizing metabolic enzymes and triggering specific chemical signals, galectin-4 forces the tumor into a state of metabolic adaptation that effectively shields it from the immune system. This process creates a hostile environment that neutralizes protective T cells while attracting suppressive cells that prevent the therapy from working. Ultimately, the study suggests that measuring galectin-4 levels can predict patient outcomes, and blocking this protein may provide a vital strategy for restoring the effectiveness of life-saving cancer treatments.