Epithelial-to-mesenchymal transition (EMT) determines the most lethal features of cancer, metastasis formation and chemoresistance, and therefore represents an attractive target in oncology. However, direct targeting of EMT effector molecules is, in most cases, pharmacologically challenging. Since emerging research has highlighted the distinct metabolic circuits involved in EMT, we propose the use of metabolism-specific inhibitors, FDA approved or under clinical trials, as a drug repurposing approach to target EMT in cancer. Metabolism-inhibiting drugs could be coupled with standard chemo-or immunotherapy to combat EMT-driven resistant and aggressive cancers.
Clinical Manifestations of EMTEMT, a classical developmental phenotypic plasticity program, is governed by the switching in the epithelial phenotype of a cell to mesenchymal form conferring various biological processes such as in gastrulation, neural crest migration, and wound healing [1]. Cancer being a highly heterogeneous disease known for its accumulations of various abnormalities in the cell, often recapitulates and manipulates the developmental EMT program in a partial and transient fashion to acquire advantageous features for its survival and propagation [2]. The EMT phenomenon is mediated through multiple transcription factors, aiding enhanced invasive ability, dissemination to distant sites, metastatic colonization, cancer stemness, and chemoresistance [3,4]. In some tissues, the EMT process has also been observed in the fundamental early steps of tumorigenesis [5,6]. Recent evidence highlighted that cancer cells that have undergone full EMT possess less metastatic potential, while cells in the partial or hybrid state inherently contain a high degree of plasticity and metastasis-initiating ability [7][8][9]. Dissemination of tumor cells as clusters by collective migration has also been proposed to be regulated through EMT-dependent mechanisms [10].
HighlightsEpithelial-to-mesenchymal transition (EMT), an embryonic phenotypic plasticity program, in cancer confers invasiveness, dissemination, and chemo/ immunotherapy resistance.