Metabolic reprogramming is not only an emerging hallmark of cancer, but also an essential regulator of cancer cell adaptation to the microenvironment. Metabolic imaging targeting metabolic signatures has been widely used for breast cancer diagnosis. However, limited implications have been explored for monitoring breast cancer therapy response, although metabolic plasticity is notably associated with therapy resistance. In this review, we focus on the metabolic alterations upon breast cancer therapy and their potential for evaluating breast cancer therapeutic responses. We summarize the metabolic network and regulatory changes upon breast cancer therapy in terms of cancer pathological and genetic differences and discuss the implications of metabolic imaging with various probes in selecting target beneficiaries for precision treatment.
Key metabolic reprogramming of breast cancer in response to therapyReprogramming of glucose metabolism upon breast cancer therapy Drug-resistant breast cancer cells are able to reprogram glucose metabolism to adapt to the stress induced by drug treatment (Figure 1). For example, breast cancer cells resistant to lapatinib, a dual inhibitor of dermal growth factor receptor (EGFR) and HER2, recover the Highlights Reprogramming of metabolic pathways is pivotal for the adaptation and resistance to antitumor treatments in breast cancer.Metabolic changes upon treatment are superior to single timepoint metabolic signals in monitoring breast cancer therapeutic response.Cancer genetic and metabolic heterogeneity need to be fully integrated to precisely predict breast cancer response to different treatments.Metabolic imaging guided usage of anticancer drugs is critical for precise treatment in breast cancer.