Recent advances in the role of AMP-activated protein kinase in metabolic reprogramming of metastatic cancer cells: targeting cellular bioenergetics and biosynthetic pathways for anti-tumor treatment.

Growing data indicate that tumor progression and metastasis is dependent on the reprograming of cellular metabolism. Rapidly growing cancer cells undergo metabolic stress in a harsh microenvironment. AMP-activated protein kinase (AMPK) is an energy sensing factor that regulates bioenergetics and biosynthetic pathways within the cell, but its role under metastasis is in dispute. The best studied phenotype of cancer cells is aerobic glycolysis (the Warburg effect), an increased catabolism of glucose to lactate. However, glycolysis and mitochondrial oxidative phosphorylation may operate simultaneously in cancer cells. Many tumors may switch between these pathways accordingly to the current requirements. The alterations in metabolism of cancer cells combined with the overexpression of oncogenes (c-Myc) and transcription factors (Hypoxia-inducible factor 1a) confer a great advantage to malignant cells to avoid reactive oxygen species induced apoptosis. The determination of the role of AMPK network in metabolic reprogramming of metastatic cancer cells may help to identify the selective molecular targets for efficient anti-cancer therapies. In this review, we discuss the implications of AMPK activation in metabolic reprogramming of cancer cells and we present several potential therapeutic strategies targeting cancer cell metabolism. AMPK activator, biguanide metformin, either alone or in combination with other drugs, may selectively modulate signaling pathways, expresses the chemopreventive potential and can be used in current anti-cancer approaches. However, the ambiguous data suggest that the activation of AMPK may induce multiple effects and thus potential therapeutic anti-cancer approach should be carefully considered in relation to metabolic network of cancer cell signaling and other determinants such tumor stage and origin as well.