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mTOR such as buparlisib, everolimus, and temsirolimus have demonstrated only modest success in
advanced TC [160-164] . Patients exhibited reduced tumor burden initially, but drug resistance and relapse
inevitably occurred. As the field in TC metabolism advances, we will need a more thorough delineation of
enzyme expression patterns and metabolite levels to formulate the most specific and effective targeted
strategies for improving clinical outcomes.

DECLARATIONS
Acknowledgments
We thank Dr. Eyal Amiel (Department of Biomedical and Health Sciences, University of Vermont) for
lending his expertise in metabolism for thoughtful contributions to editing. All figures were generated using
BioRender.com. Figures 1 and 6 were adapted from premade templates: Glycolysis and Glycolytic Enzymes
and PI3K/Akt, RAS/MAPK, JAK/STAT Signaling.

Authors’ contributions
Drafted the manuscript and figures: Davidson CD
Provided assistance with planning, conceptualizing, and editing: Carr FE

Availability of data and materials
Not applicable.

Financial support and sponsorship
Davidson CD is supported in part by the University of Vermont Cancer Center.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

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