Genome-scale metabolic reconstructions; Metabolism in cancer; Metabolome; Precision medicine; Systems biology
The discovery that the metabolism of cancer cells is different from non-malignant cells is not new, this finding was described more than a century ago by O. Warburg. Nevertheless, in the last decade the technologies such as capillary electrophoresis, mass spectroscopy (MS), and proton nuclear magnetic resonance spectroscopy (H-NMR) have allowed deciphering the complexity and heterogeneity underlying the cancer metabolism. These high-performance technologies are generating a large amount of data that requires conceptual schemes and approaches to efficiently extract and physiologically interpret the dynamic spectrum of the metabolome data in cancer samples. Breast cancer is a disease that highlights the need to develop computational schemes to systematically explore the metabolic alterations that support the malignant phenotype in human cells. Hence, systems biology approaches with capacities to integrate in silico modeling and highthroughput data are very attractive for clinicians to make oncological treatment decisions combined with static parameters such as clinical and histopathological variables. In this chapter we present a cutting-edge review, perspectives and scope of how metabolic approaches in breast cancer studies can be used not only to integrate the local and systemic response of the host, but also as a technique to look for metabolic biomarkers by non-invasive and simpler sample procedure in biofluids such as serum, saliva, urine, pleural fluid, breath, and ascites. We discuss how the "metabolic phenotype" approach could contribute to developing a personalized medicine by combining metabolome data and computational modeling to evaluate some clinical variables such as detection of relapses, monitoring and response prediction to treatment and toxicity prediction in patients. Even though some advances have been accomplished, in practice there are many challenges and limits that will have to be broken before the metabolomics can be integrated into the day-to-day clinic. Despite this situation, it is evident that the translational multidisciplinary approach combined with the rapid technological development and the correct data interpretation will bring in the future tools for improving outcomes in the clinical area. © Springer International Publishing AG 2018. All rights are reserved.