PerspectiveCancer Metabolism

The nutrient environment affects therapy

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Science  01 Jun 2018:
Vol. 360, Issue 6392, pp. 962-963
DOI: 10.1126/science.aar5986

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Understanding the molecular basis of cancer has led to a revolution in how cancers are classified and treated. Subsets of patients benefit from precision-medicine drugs that target growth-promoting signaling networks, but not all cancer patients respond to these approaches (1). Precision medicine is largely built on the assumption that cancer cell–intrinsic factors, such as genetic mutations or epigenetic identity, determine which pathways and processes are required in cells and thus response to therapies. However, in many cases, the presence of particular genetic lesions is insufficient to identify patients that will respond to a drug (1). For instance, standard cell culture models have not identified the subsets of cancer patients that respond to most conventional chemotherapies (1). Nevertheless, these chemotherapy drugs remain standard of care for many cancers and, in some cases, contribute to curative regimens. Emerging data suggest that beyond cell-intrinsic factors, nutrient availability in the tumor microenvironment can also influence drug response. This highlights the importance of understanding the microenvironmental factors that dictate which cellular processes are essential for disease progression and ultimately how tumors respond to treatments that target these processes.