Treatments and Technologies of Cancer metabolism | Oncology

Cancer metabolism

What is cancer metabolism?

Cancer metabolism is the process by which cancer cells produce the energy they need to grow and spread. It is aimed at researchers working to stop or slow cancers. Metabolism is the way your body cells use carbohydrates, fats, and proteins in food to get the energy they need to grow, reproduce, and stay healthy. Cancer cells act differently. Compared to healthy cells, they use more glucose (a type of carbohydrate). And they generate less energy while doing the necessary to multiply and spread. One of the goals is to stop this process when healthy cells are left alone.

Target treatments

These are new approaches to cancer treatment. Unlike chemotherapy and radiation, targeted therapies do not kill cancer cells right away. Instead, they prevent cancer cells from growing by altering or slowing down the metabolism of cancer. The tumor eventually shrinks and dies.

Because of the way they work, targeted therapies primarily affect cancer cells, leaving only normal, healthy cells. They don’t kill cancer cells right away. They stop copying themselves and making new ones. Therefore, they do not damage normal healthy cells in the same way that chemotherapy does.

Targeted therapies can be used to treat bladder, breast, lung, lung, kidney, gastric (melanoma), melanoma, some types of leukemia and lymphoma, and other types of cancer.

New approaches

Researchers are working to find new ways to prevent cancer metabolism. This work is in its infancy, primarily in laboratory studies and tests on animals. It is not yet ready for public use. Potential targets:

  • Glucose: Early lab studies have shown that glucose-lowering drugs or dietary changes (or both) can help treat cancer. It is very fast to know if it works in people, what is the best plan, or what types of cancer it works for.
  • Amino acids: Cancer cells also use amino acids, which form building blocks for proteins in your body. Targeting some will stop the supply of “food” for cancer.
  • Cancer messaging systems: Some cancer cells contain certain types of proteins and enzymes that are different from normal cells. They send messages to grow and spread. Medicines can block or stop the signals that these messages send or tell cancer cells to destroy themselves.
  • Another area of research in nutrition: Part of this work looks at the effects of fasting and ketogenic diets. If you are considering food as a way to specifically target cancer metabolism, keep in mind that there are no guidelines yet on how to do this. Experts recommend that people with cancer eat and drink a wide variety of foods that provide nutrients such as vitamins, minerals, protein, carbohydrates, fats, and water. The American Cancer Society recommends eating a variety of vegetables, fruits, whole grains, beans, and legumes, and limiting red meat, processed meats, sugary drinks, and excessively processed foods.

Importance of cell metabolism in cancer

“Metabolic changes in the past were thought to be secondary to other major tumorigenic events, and we now know that they are critical for tumor growth,” said Doctors. “For example, there is evidence that many tumor inhibitors or oncogenes induce expression changes in metabolic genes that contribute to tumorigenesis. This has led to a resurgence in cancer metabolism research. ”

Consequently, much of the research on cancer metabolism over the past 15 years has focused on the autonomous metabolic changes of cancer cells, Anastasia explains. However, it is now clear that whole-body metabolic changes may be associated with tumor metabolism and that these changes are clinically important. “There are important clinical phenotypes such as cachexia, loss of muscle mass, and adipose tissue, which significantly affect the quality of life of patients. Although these systemic changes have been known for a long time, the clinical picture in this area is a relatively new vision for the entire field. ”

Progress in targeting metabolic pathways in cancer

To date, two main metabolic pathways have attracted much attention in cancer research: glucose metabolism by glycolysis and glutamine by the Krebs cycle (TCA). Glucose has received considerable attention because many tumors have taken it with interest, as evidenced by the use of glucose as a tracer in positron emission tomography (PET) scans. However, researchers still do not fully understand the role of pathogens in cancer pathogenesis.

“The idea that glucose provides building blocks for biosynthesis in cancer has been around for a long time. Although we can figure out where the glucose carbon molecules go, we do not fully understand the importance of redistributing that metabolism in different metabolic pathways, ”explains Anastasia.

In addition to trying to understand the glycolytic and glucose pathway in cancer, researchers are now exploring how it may interfere with other metabolic pathways, such as amino acid metabolism, to prevent cancer development 2, and the role of other processes such as lipid and nucleotide biosynthesis towards a new approach.

If something can be used as an example of the possibility of targeting metabolism for cancer treatment, it could be the enzyme isocitrate dehydrogenase (IDH), which is mutated in the ratio of gliomas and glioblastomas, Anastasia.

“Discovering the role of the mutated HDI is a breakthrough because it reinforces the idea that metabolic changes can lead not only to bystanders but also to the development of cancer by themselves.”, He explained, “but with IDH mutations, this problem is solved beforehand because it is possible to test for enzyme mutations and we have a biomarker automatically to apply these drugs targeting IDH. It can be a big challenge to target other metabolic processes – easily accessible biomarkers or How do you add metabolic therapies to the tests? ”

Technologies for studying cancer metabolism

Fortunately, new technologies allow metabolism to be classified in unprecedented detail and can provide non-invasive options for identifying metabolic biomarkers.

At the UK Beatson Institute for Cancer Research in Glasgow, David Lewis, Ph.D., group leader of the Molecular Imaging Laboratory, is developing advanced PET imaging techniques to study a wide range of metabolisms in Live. “When you look at the area of   cancer metabolism, which is much higher than glucose, there is a real possibility that the technical potential that we have with PET imaging can be applied to other types of metabolism.”

One of the most exciting developments in the Louis field last year was the advent of whole-body pet scanners, now FDA approved, which produce stunning images of dynamic metabolic processes throughout the body. “Investigating the relationship between a tumor and its host is critical, because not every tissue in the body can be biopsied,” Lewis explained. “With whole-body PET imaging, we can visualize the metabolism of the tumor and the host simultaneously, so this is a very important way to detect cancer therapies in the host and ultimately monitor their efficacy.”

A great advantage of PET is that it is a destructive technology: “We don’t have to take a piece of tissue and break it down, we can see it in its natural place. And we see radioactivity, which is a very powerful process, the technology is very sensitive, going down to picomolar concentrations of metabolism. This means that the system is not affected when we are obtaining images. Other methods are similar to the challenging experiment: here you can see what the metabolic surface of the tumor is doing with the “load”, but you can see what the tissue is doing locally with the pet. ”

Louis wants to use PET to understand the metabolic diversity of tumors and how it changes over time. “We have some good models and we are focusing on lung cancer because it is a very different disease. In addition to using fluorodeoxyglucose that is used in diagnostic pets, we are using another molecule called 11C-acetate, which can metabolize many mitochondrial organisms. in lipids de novo “. It is a surface for the passages, so we are allowed to separate some of them.

One application of this research is to identify areas of high or complete metabolism in tumors that can aid in treatment. This is limited to radiation therapy, where hypoxic areas are “painted over” on scans before intensity-modulated radiation therapy. But this is just the beginning, says Louis: “If we can understand what molecular mechanisms are in different regions, we can compare those subgroups with resistance to radiation therapy or use the information to rationally combine treatments.”

One of the challenges is to be guided by metabolic symptoms or to use drugs targeting metabolism, we don’t know how plastic these processes are. “As tumors develop, there will inevitably be some resistance to metabolic therapies, but we will be able to monitor noninvasive metabolic imaging serially after starting treatment so we can monitor it and receive appropriate treatment.” Ultimately, it is hoped to build an integrated diagnostic and therapeutic line, where it can be integrated.

Where next for cancer metabolism?

While the concept of targeting cell metabolism in cancer is not new, there is a new appetite to understand its implications and plunder it through multiple diagnostic treatment strategies. What is needed now is to look at the problem through a different lens, says doctor:

  • “When you talk to people in this field, it is clear that things are much more complicated than they seem. With the advent of exciting new technology, it is good to find rational ways to understand and exploit this complexity.
  • For me, the most important question is how cancer metabolism and host metabolism interact with each other; What are cause and effect, and what are the signs that initiate this communication? I hope that we can cure your tumors if we intervene in this phenomenon, but even if we can’t, we hope to find ways to improve your quality of life.”

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