Therapeutic Approaches Targeting Glucose, Glutamine and Lipid Metabolism in Multiple Myeloma

Multiple changes in the cancer-causing genes convert the normal cells into cancer phenotypes characterized by prolonged proliferative signalling, resistance to cell death, stimulation of vascular growth for oxygen and nutrient supply (angiogenesis), active invasion, and metastasis. Some of these phenotypic changes are metabolic adaptations such as increased glycolysis or glutaminolysis. It is possible to encounter these adaptations in many cancers including multiple myeloma (MM) which is defined as malignant proliferation of bone marrow by clonal plasma cells. In recent years, it has been remarkable that studies have focused on understanding the metabolic adaptation processes of cancer cells and thus retard the progression of the tumour and develop treatment strategies that result in a positive clinical outcome. Increased glycolysis and glutaminolysis are prominent metabolic adaptations in MM cells compared to healthy cells. However, studies with MM are more limited than other malignancies. In this review, the differences in cellular oncoproteins, metabolites and enzymes that contribute to metabolic adaptations in MM cells and treatment approaches targeting these processes will be discussed.