Cancer as a Metabolic Disorder

I received an inquiry via Twitter “Has anyone thought about using a sugar medium (similar to PET scans) to deliver chemo drugs?”

Although no one would use PET scans nor the PET reagents as therapy, the question is actually profound. There is a growing recognition that cancer is not a genetic disease but instead a metabolic disorder. One could not attend a lecture at the American Association of Cancer Research without there being reference to Otto Warburg’s 1956 paper “On the Origin of Cancer Cells” that described the metabolic basis of human malignancy.

Despite our myopic focus on cancer genomics, there is a growing recognition that cancer represents dysregulated energy metabolism. The high utilization of glucose, a hallmark of malignantly transformed cells, (and the target of PET scan diagnostics), in part reflects the process of aerobic glycolysis, whereby cells provided ample oxygen nonetheless eschew the efficiency of mitochondrial oxidative phosphorylation in favor of seemingly inefficient lactate production.

Into this new realm of biochemically driven developments, a growing number of therapeutic agents that target glucose metabolism are finding their way into the clinic. To the dismay of some, the mutations that our molecular biologists identify are increasingly found to represent intermediates of cellular metabolism, forcing many to go back to relearn biochemistry. Thus, the avidity for glucose represented by uptake of the PET scan reagent F18 fluorodeoxyglucose by tumor cells, is a diagnostic application of what, in the future, may provide meaningful therapeutic opportunities.

Looking Forward to TEDxSoCal

I remember my first recollection of the TED (Technology Entertainment Design) conferences, which have been held annually for almost two decades. Drawing together innovators in a broad spectrum of disciplines, these programs have become an institution unto themselves. With invited speakers ranging from Harvard’s Edward O. Wilson to business leaders, like Microsoft’s Bill Gates, the lectures cover a panoply of interesting topics.

It was with a sense of delight that I received an invitation to speak at the TEDxSoCal conference on July 16 at the Long Beach Terrace Theater. As the date approaches, I am looking forward to the event with great anticipation. Since the event is sold out, I understand I’ll have 800 attendees in the audience.

What an interesting opportunity to engage this group in a discussion of cancer biology with our focus on biochemistry and metabolism. This is timely in the context of Gina Kolata’s recent article in the New York Times on the failures of genomics platforms in the field of functional profiling for cancer treatment.

I will report next week on this experience.