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CancersCancers
  • Review
  • Open Access

18 October 2026

27 Pages

Cancer Cell Metabolic Reprogramming: Dietary, Pharmacological Strategies and Clinical Perspectives

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Global Business School for Health, University College London, London WC1E 6BT, UK
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Third Department of Internal Medicine, Sotiria General Hospital for Chest Diseases, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Department of Basic and Clinical Sciences, Medical School, University of Nicosia, UNIC Athens, 16777 Athens, Greece
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Department of Pathology and Surgery, Hygeia Hospital, 15123 Athens, Greece
This article belongs to the Special Issue Mitochondrial Metabolism and Cancer

Simple Summary

Cancer cells change the way they use nutrients and produce energy in order to grow, survive, and resist treatment. Targeting these metabolic changes through dietary changes or drugs is therefore emerging as a promising approach in cancer research. In this review, we explain how changing the calories or the nutrients of the food we consume, eating only at certain times of the day, or drugs that have similar effects as those dietary changes may influence tumor growth and the tissues around the tumor. We also discuss how modern technologies can help identify changes caused by these interventions on the molecular and metabolic level. Evidence from laboratory studies, animal models, and clinical observations suggests that modifying cancer metabolism may help slow tumor progression and improve responses to existing treatments. Further clinical research is needed to determine how these strategies can be safely and effectively incorporated into cancer care.

Abstract

Metabolic reprogramming, a key feature of cancer progression that enables tumor adaptation to stress and therapy, represents an emerging target in anticancer research through dietary and pharmacological modulation. Dietary strategies such as caloric restriction (CR), intermittent fasting, and nutrient-specific modifications are emerging approaches to target oncogenic metabolism. Preclinical studies show that CR reduces tumor burden and inhibits IGF-1/mTOR signaling, while restoring immune pathways. Complementary preclinical evidence confirms that pharmacological inhibitors of the IGF-1R and mTOR pathways independently expose metabolic vulnerabilities, while concurrent autophagy blockade alongside mTOR inhibition can further reduce cancer cell viability by preventing stress adaptation. Multi-omics analyses facilitate the identification of how dietary restriction and pharmacological interventions remodel the tumor microenvironment by altering immune infiltration and stromal interactions, and uncover metabolic dependencies, that represent actionable therapeutic vulnerabilities. These findings suggest that dietary and pharmacological metabolic modulation represents an innovative approach in anticancer research. Preclinical models demonstrate the capability of these interventions to suppress tumor growth and enhance therapeutic responses, while early-phase clinical trials currently establish their safety and biological feasibility. In this review, we aim to summarize findings from in vitro models, in vivo animal studies, clinical observations, and multi-omics analyses to assess the potential of diet and pharmacological mimetics in influencing tumor metabolism and the tumor microenvironment.

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