Over 80 years ago, world-renowned biochemist Otto Heinrich Warburg observed that cancer cells exhibited high glycolysis (glucose conversion to lactic acid) even in the presence of oxygen (Warburg effect). However, not until the last decade did the reprogramming of cellular metabolism regain deserved attention for its role in cancer.
A number of common oncogenes and tumor suppressor genes have been discovered that directly control cell metabolism. In addition, a number of metabolic enzymes causally mutated in a variety of human cancers including hematological malignancies have now been identified as human tumor suppressors or oncogenes. The reprogramming of metabolic pathways is essential for tumors to survive and proliferate in their microenvironment. As a result of these more recent developments, several pharmacologic therapies have been developed and are currently under evaluation in clinical trials for their safety and efficacy in the treatment of both solid and hematologic cancers.
Cancer cell metabolism and the Warburg effect are promising targets for cancer treatment. However, physicians may lack the clinical and biochemical knowledge of the basic science behind the Warburg effect. In addition, physicians may not be up-to-date on the agents that are currently under evaluation in clinical trials. Some of these agents are in late-stage clinical trials and have demonstrated promising results. Therefore, it is important that physicians understand the basic science of the Warburg effect and the emerging pharmacologic agents that may reach the clinic, which may provide important additional options for the treatment of cancer. This knowledge will allow physicians to effectively implement these new therapies in their clinical practice, potentially improving patient outcomes and quality of life.
- Describe how metabolic reprogramming contributes to tumor transformation and sustains progression in blood cancer cells
- Assess the therapeutic potential of targeting metabolic changes as they relate specifically to hematologic malignancies
- Apply new strategies for incorporating therapies that target metabolism in blood cancers
- Utilize the information presented from current and future clinical trials that evaluate cancer metabolism in order to better manage patients with hematologic malignancies
- Explain the basis for therapies that affect cancer cell metabolism
Chi V. Dang, MD, PhD
John H. Glick, MD, Professor of Medicine
Director, Abramson Cancer Center
University of Pennsylvania
Perelman School of Medicine
Jeffrey C. Rathmell, PhD
Department of Pharmacology and Cancer Biology
Department of Immunology
Sarah W. Stedman Nutrition and Metabolism Center
Mariusz A. Wasik, MD
Department of Pathology
University of Pennsylvania
Perelman School of Medicine
Ayalew Tefferi, MD
Professor of Medicine
Division of Hematology
John L. Cleveland, PhD
Professor and Chair
Department of Cancer Biology
The Scripps Research Institute
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 3.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
- John L. Cleveland, PhD, has no affiliations with commercial interests to disclose.
- Chi V. Dang, MD, PhD, has no affiliations with commercial interests to disclose.
- Jeffrey C. Rathmell, PhD, has affiliations with Lycera (Consulting Fees).
- Ayalew Tefferi, MD, has no affiliations with commercial interests to disclose.
- Mariusz A. Wasik, MD, has no affiliations with commercial interests to disclose.
The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
THE LEUKEMIA & LYMPHOMA SOCIETY
- Richard C. Winneker, PhD, has no affiliations with commercial interests to disclose.
- Cynthia M. Kunzer has no affiliations with commercial interests to disclose.
- Emma Hitt, PhD, has no affiliations with commercial interests to disclose.
Postgraduate Institute for Medicine
The following PIM staff serve as clinical content reviewers and/or participate in planning CME/CE activities in a manner that may affect content: Laura Excell, ND, NP, MS, MA, LPC, NCC; Trace Hutchison, PharmD; Samantha Mattiucci, PharmD; Jan Schultz, RN, MSN, CCMEP; and Patricia Staples, MSN, NP-C, CCRN, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interests related to the content of this CME/CE activity of any amount during the past 12 months.
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This activity is jointly sponsored by The Leukemia & Lymphoma Society, RMEI, LLC and Postgraduate Institute for Medicine and supported by an educational grant from Celgene Corporation.
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