Cancer cells change their glucose metabolism to overcome increased ROS: One step from cancer cell to cancer stem cell?

Biomed Pharmacother. 2019 Apr;112:108690. doi: 10.1016/j.biopha.2019.108690. Epub 2019 Feb 22.


Cancer cells can adapt to low energy sources in the face of ATP depletion as well as to their high levels of ROS by altering their metabolism and energy production networks which might also have a role in determining cell fate and developing drug resistance. Cancer cells are generally characterized by increased glycolysis. This is while; cancer stem cells (CSCs) exhibit an enhanced pentose phosphate pathway (PPP) metabolism. Based on the current literature, we suggest that cancer cells when encountering ROS, first increase the glycolysis rate and then following the continuation of oxidative stress, the metabolic balance is skewed from glycolysis to PPP. Therefore, we hypothesize in this review that in cancer cells this metabolic deviation during persistent oxidative stress might be a sign of cancer cells' shift towards CSCs, an issue that might be pivotal in more effective targeting of cancer cells and CSCs.

Keywords: Cancer cell; Cancer stem cell; Glycolysis; Pentose phosphate pathway; ROS.

Publication types

  • Review

MeSH terms

  • Animals
  • Energy Metabolism / physiology
  • Glucose / metabolism*
  • Glycolysis / physiology
  • Humans
  • Neoplasms / metabolism*
  • Neoplasms / pathology
  • Neoplastic Stem Cells / metabolism*
  • Neoplastic Stem Cells / pathology
  • Oxidative Stress / physiology*
  • Reactive Oxygen Species / metabolism*


  • Reactive Oxygen Species
  • Glucose