New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis

The incidence of renal malignancies is increasing each year. Clear cell renal cell carcinoma (ccRCC) accounts for approximately 80% of all renal malignancies. Its unique genetic background and mutation features involve dysregulation of homeostasis within the tumor microenvironment (TME) represented...

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Main Author: SU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei
Format: Article
Language:English
Published: Editorial Office of China Oncology 2022-04-01
Series:Zhongguo aizheng zazhi
Subjects:
Online Access:http://www.china-oncology.com/fileup/1007-3639/PDF/1651908564155-255018809.pdf
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author SU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei
author_facet SU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei
author_sort SU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei
collection DOAJ
description The incidence of renal malignancies is increasing each year. Clear cell renal cell carcinoma (ccRCC) accounts for approximately 80% of all renal malignancies. Its unique genetic background and mutation features involve dysregulation of homeostasis within the tumor microenvironment (TME) represented by pathways such as hypoxic signaling, glycolytic metabolism, amino acid metabolism, and mitochondrial oxidative phosphorylation. Immune checkpoint inhibitor (ICI) in combination with tyrosine kinase inhibitor (TKI) has become the first line of treatment for patients with advanced ccRCC. However, the efficacy of combination therapy has yet to be improved, and there is an urgent need for biomarkers that can assist the diagnosis, treatment, and prognosis. Multi-omics studies have investigated aberrant abnormalities in molecular pathways of ccRCC in recent years. The ccRCC undergoes metabolic reprogramming and prefers inefficient glycolysis as a significant energy source even under normoxia to support unlimited proliferation. In addition, abnormalities in the aerobic glycolytic pathway have been associated with poor prognosis. Dysregulated glycolytic signaling promotes tumor progression and interacts with immune cells within the TME in ccRCC, resulting in an imbalance between pro and antitumor immunity, creating a suppressive immune microenvironment, promoting tumor immune escape, and impairing antitumor effects of immunotherapy. Therefore, integrating the aerobic glycolytic pathway and the immune microenvironment as an entry point, limiting tumor progression by restricting aberrant glycolytic metabolism broadens therapeutic options for ccRCC and pan-cancer treatments. However, further research is required on maximizing the metabolic reprogramming that tumor cells harbor in the complex TME to convert it into a therapeutic target and apply it in clinical practice. Glycolytic inhibitors in combination with ICI or TKI might be a novel strategy that demonstrates synergistic antitumor effects and overcomes resistance in treating human cancers. This review analyzes the correlations between essential rate-limiting enzymes, transporters, glycolytic pathway inhibitors, and the tumor immune microenvironment in ccRCC. Then we summarize the effects of glycolytic inhibitors in human cancers and alterations in the tumor immune microenvironment. Along with the potential clinical translational value in combination with targeted therapy or immunotherapy, targeting glycolysis will provide new insights for the clinical treatment of ccRCC and bring clinical benefits to patients in the future.
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spelling doaj.art-8299d3e16a5a424da86ca6abffa1aaf42022-12-22T04:30:56ZengEditorial Office of China OncologyZhongguo aizheng zazhi1007-36392022-04-0132428729710.19401/j.cnki.1007-3639.2022.04.001New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysisSU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei0Department of Urology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, ChinaThe incidence of renal malignancies is increasing each year. Clear cell renal cell carcinoma (ccRCC) accounts for approximately 80% of all renal malignancies. Its unique genetic background and mutation features involve dysregulation of homeostasis within the tumor microenvironment (TME) represented by pathways such as hypoxic signaling, glycolytic metabolism, amino acid metabolism, and mitochondrial oxidative phosphorylation. Immune checkpoint inhibitor (ICI) in combination with tyrosine kinase inhibitor (TKI) has become the first line of treatment for patients with advanced ccRCC. However, the efficacy of combination therapy has yet to be improved, and there is an urgent need for biomarkers that can assist the diagnosis, treatment, and prognosis. Multi-omics studies have investigated aberrant abnormalities in molecular pathways of ccRCC in recent years. The ccRCC undergoes metabolic reprogramming and prefers inefficient glycolysis as a significant energy source even under normoxia to support unlimited proliferation. In addition, abnormalities in the aerobic glycolytic pathway have been associated with poor prognosis. Dysregulated glycolytic signaling promotes tumor progression and interacts with immune cells within the TME in ccRCC, resulting in an imbalance between pro and antitumor immunity, creating a suppressive immune microenvironment, promoting tumor immune escape, and impairing antitumor effects of immunotherapy. Therefore, integrating the aerobic glycolytic pathway and the immune microenvironment as an entry point, limiting tumor progression by restricting aberrant glycolytic metabolism broadens therapeutic options for ccRCC and pan-cancer treatments. However, further research is required on maximizing the metabolic reprogramming that tumor cells harbor in the complex TME to convert it into a therapeutic target and apply it in clinical practice. Glycolytic inhibitors in combination with ICI or TKI might be a novel strategy that demonstrates synergistic antitumor effects and overcomes resistance in treating human cancers. This review analyzes the correlations between essential rate-limiting enzymes, transporters, glycolytic pathway inhibitors, and the tumor immune microenvironment in ccRCC. Then we summarize the effects of glycolytic inhibitors in human cancers and alterations in the tumor immune microenvironment. Along with the potential clinical translational value in combination with targeted therapy or immunotherapy, targeting glycolysis will provide new insights for the clinical treatment of ccRCC and bring clinical benefits to patients in the future.http://www.china-oncology.com/fileup/1007-3639/PDF/1651908564155-255018809.pdf|clear cell renal cell carcinoma|glycolysis|metabolic reprogramming|tumor microenvironment|immunotherapy
spellingShingle SU Jiaqi, XU Wenhao, TIAN Xi, ANWAIE Aihetaimujiang, QU Yuanyuan, SHI Guohai, ZHANG Hailiang, YE Dingwei
New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
Zhongguo aizheng zazhi
|clear cell renal cell carcinoma|glycolysis|metabolic reprogramming|tumor microenvironment|immunotherapy
title New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
title_full New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
title_fullStr New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
title_full_unstemmed New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
title_short New strategies for combined with immunotherapy of clear cell renal cell carcinoma: advances in aerobic glycolysis
title_sort new strategies for combined with immunotherapy of clear cell renal cell carcinoma advances in aerobic glycolysis
topic |clear cell renal cell carcinoma|glycolysis|metabolic reprogramming|tumor microenvironment|immunotherapy
url http://www.china-oncology.com/fileup/1007-3639/PDF/1651908564155-255018809.pdf
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