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Metabolic reprogramming: the emerging concept and associated therapeutic strategies
Open accessAbstract
Tumor tissue is composed of cancer cells and surrounding stromal cells with diverse genetic/epigenetic backgrounds, a situation known as intra-tumoral heterogeneity. Cancer cells are surrounded by a totally different microenvironment than that of normal cells; consequently, tumor cells must exhibit rapidly adaptive responses to hypoxia and hypo-nutrient conditions. This phenomenon of changes of tumor cellular bioenergetics, called "metabolic reprogramming", has been recognized as one of 10 hallmarks of cancer. Metabolic reprogramming is required for both malignant transformation and tumor development, including invasion and metastasis. Although the Warburg effect has been widely accepted as a common feature of metabolic reprogramming, accumulating evidence has revealed that tumor cells depend on mitochondrial metabolism as well as aerobic glycolysis. Remarkably, cancer-associated fibroblasts in tumor stroma tend to activate both glycolysis and autophagy in contrast to neighboring cancer cells, which leads to a reverse Warburg effect. Heterogeneity of monocarboxylate transporter expression reflects cellular metabolic heterogeneity with respect to the production and uptake of lactate. In tumor tissue, metabolic heterogeneity induces metabolic symbiosis, which is responsible for adaptation to drastic changes in the nutrient microenvironment resulting from chemotherapy. In addition, metabolic heterogeneity is responsible for the failure to induce the same therapeutic effect against cancer cells as a whole. In particular, cancer stem cells exhibit several biological features responsible for resistance to conventional anti-tumor therapies. Consequently, cancer stem cells tend to form minimal residual disease after chemotherapy and exhibit metastatic potential with additional metabolic reprogramming. This type of altered metabolic reprogramming leads to adaptive/acquired resistance to anti-tumor therapy. Collectively, complex and dynamic metabolic reprogramming should be regarded as a reflection of the "robustness" of tumor cells against unfavorable conditions. This review focuses on the concept of metabolic reprogramming in heterogeneous tumor tissue, and further emphasizes the importance of developing novel therapeutic strategies based on drug repositioning.
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“In oxygenated environment, tumorous or even normal cells can consume the excreted metabolites of other cells located in the stroma.”
From Hypoxia Signaling in Cancer: From Basics to Clinical Practice (2021) · cites this paper as [37]
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“lactate produced during “lactic glycolysis” of hypoxic or pseudo-hypoxic cells can be utilized in this manner [37] (Figure 6).”
From Hypoxia Signaling in Cancer: From Basics to Clinical Practice (2021) · cites this paper as [37]
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Metadata
- Authors
- Yoshida, G. J.
- Affiliations
- Tokyo Medical and Dental University (JP)
- Corresponding author
- Yoshida, Go J.
- ORCID
- Yoshida, Go J.
- Venue
- Journal of Experimental & Clinical Cancer Research
- Published
- 2015-10-06
- Volume
- 34
- Issue
- 1
- Pages
- 111-111
- ISSN
- 0392-9078 (ISSN-L)
- 1756-9966
- PMC
- PMC4595070
- OpenAlex
- W2114090713
- Cited by
- 716
- References
- 89
- Citations by year
- 2026: 60 · 2025: 83 · 2024: 99 · 2023: 77 · 2022: 80 · 2021: 91 · 2020: 71 · 2019: 46 · 2018: 45 · 2017: 35 · 2016: 27 · 2015: 2
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Experimental & Clinical Cancer Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Keio University
- Japan Society for the Promotion of Science (15J02898)
- 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
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Keywords
- metabolic reprogramming, Warburg effect, aerobic glycolysis, mitochondrial metabolism, tumor microenvironment, cancer-associated fibroblasts, reverse Warburg effect, monocarboxylate transporters, lactate, metabolic heterogeneity, metabolic symbiosis, cancer stem cells, chemoresistance, drug repurposing, tumor stroma, tumor heterogeneity
- MeSH terms
- Cellular Reprogramming Techniques, Antineoplastic Agents, Cell Transformation, Neoplastic, Energy Metabolism, Glycolysis, Humans, Mitochondria, Neoplasms, Oxidative Phosphorylation, Neoplastic Stem Cells, Drug Resistance, Neoplasm, Tumor Microenvironment
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