Mechanisms, impacts and therapeutic strategies of glucose metabolic reprogramming in tumours

Abstract Background Glucose metabolic reprogramming is a hallmark of cancer, best exemplified by the Warburg effect. It plays a central role in driving tumour growth, metastasis and resistance to therapy. Main Findings This review systematically delineates the molecular underpinnings of this metabolic shift, encompassing the roles of key glycolytic enzymes, transporters, oncogenic signalling pathways and multilayered epigenetic regulation. We further propose a novel framework that conceptualizes glucose metabolism as an integrated system for signal transduction and niche engineering, which remodels the tumour microenvironment to promote immunosuppression. Translational Significance Finally, we highlight the translational applications of these insights, including metabolic imaging for diagnosis and prognosis and therapeutic strategies targeting glycolytic pathways, applied both as monotherapies and in rational combinations with conventional and emerging treatments. Conclusion Targeting glucose metabolic reprogramming offers a promising perspective and novel strategies for cancer diagnosis and therapy.