Cited by 11Cancer, Hypoxia, and MetabolismMetabolism, Diabetes, and CancerCancer, Lipids, and Metabolism

Metabolic reprogramming: The driving force behind cancer drug resistance

El-Sehrawy, Amr Ali Mohamed Abdelgawwad, Hsu, Chou-Yi, Alkhathami, Ali G., Chandra, Muktesh, Basunduwah, Tina Saeed, Malathi, H., Senapati, Jitendra Narayan, Gautam, Apurav +2 more·2025·Seminars in Oncology

Abstract

Metabolic reprogramming enables stress adaptation of cancer cells to treatment and is a primary causative force of drug resistance. Dysregulation of glucose, amino acid, and lipid metabolism supplies energy, biosynthetic precursors, and redox balance, promoting survival in the treated tumor. These processes are coordinated by oncogenic signaling, loss of tumor suppressors, and regulatory non-coding RNAs, which promote cancer stemness, immune evasion, and resistance to apoptosis. This review examines the mechanisms by which central metabolic pathways, particularly glycolysis, glutamine metabolism, and fatty acid synthesis, are altered to facilitate drug resistance in various types of cancer. Additionally, we report on novel therapeutic approaches that exploit such metabolic weaknesses to prevent therapy resistance and enhance clinical outcomes. Future directions emphasize the need for advanced metabolic profiling to personalize treatment approaches and the clinical translation of promising preclinical findings to overcome this significant obstacle in cancer therapy.

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Crossref · 10.1016/j.seminoncol.2025.152392

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186 of 186 references verified0 citation errors · 0 not checkable

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Authors
El-Sehrawy, A. A. M. A., Hsu, C.-Y., Alkhathami, A. G., Chandra, M., Basunduwah, T. S., Malathi, H., Senapati, J. N., Gautam, A., Kadhem, M., & Yasin, H. A.
Affiliations
  • Chia Nan University of Pharmacy and Science (TW)
  • King Khalid University (SA)
  • Marwadi University (IN)
  • Jain University (IN)
  • Institute of Medical Sciences and Sum Hospital (IN)
  • Chitkara University (IN)
  • Islamic University of Najaf (IQ)
  • Al-Nisour University (IQ)
Corresponding author
Hsu, Chou-Yi
Venue
Seminars in Oncology
Publisher
Elsevier BV
Published
2025-10
Volume
52
Issue
5
Pages
152392
ISSN
0093-7754 (ISSN-L)
OpenAlex
W4412470240
Cited by
11
References
192
Citations by year
2026: 9 · 2025: 2
FWCI
1.13
Type
journal article
Language
en
Open access
closed
Locations
  • Seminars in Oncology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Deanship of Scientific Research, King Khalid University (RGP.02/725/46)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
Keywords
tumor metabolic reprogramming, drug resistance, glycolysis, glutamine metabolism, fatty acid synthesis, glucose metabolism, amino acid metabolism, lipid metabolism, redox homeostasis, oncogenic signaling, tumor suppressor loss, non-coding RNA, cancer stemness, immune evasion, apoptosis resistance, metabolic therapy, metabolite profiling
MeSH terms
Metabolic Reprogramming, Animals, Antineoplastic Agents, Energy Metabolism, Glutamine, Glycolysis, Humans, Neoplasms, Drug Resistance, Neoplasm, Metabolic Networks and Pathways, Cellular Reprogramming

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