This may be due to the expression of hyaluronidases and matrix metalloproteinases, such as MMP-2 and MMP-9, among advanced and metastatic cancers that cleave ECM (including hyaluronic acid) and reduce cell-ECM contacts, adhesion, and the associated intracellular signaling [23,24]. Here, MMP9 is linked to metastatic malignant neoplasm.