Adipocytes in cancer a metabolic paradox and the dawn of novel therapeutics

In recent years, the dual regulatory role of adipocytes in the tumor microenvironment (TME) has emerged as a critical focus in cancer research. Advances in the fields of metabolic biology and tumor immunology have shown that adipocytes play a crucial role in tumor occurrence, progression, and treatment outcome by secreting adipokines, regulating metabolic reprogramming, and mediating immunosuppressive networks. This article systematically reviews the physiological functions of adipose tissue and its intricate crosstalk with cancer cells, with particular emphasis on dual metabolic and immune mechanisms by which adipocytes dynamically modulate tumor progression within the TME. Furthermore, by integrating preclinical research and translational medicine evidence, a precise treatment framework targeting the interaction between fat and tumor is proposed, providing theoretical basis for the development of metabolic immune combination therapy.