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Rizzieri et al. J Cancer Metastasis Treat 2019;5:26 Journal of Cancer
DOI: 10.20517/2394-4722.2019.05 Metastasis and Treatment

Review Open Access

Metabolic alterations and the potential for targeting
metabolic pathways in the treatment of multiple

myeloma

Dustin Rizzieri, Barry Paul, Yubin Kang

Division of Hematological Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC 27710, USA.
Correspondence to: Dr. Yubin Kang, Division of Hematological Malignancies and Cellular Therapy, Duke University Medical
Center, DUMC 3961, 2400 Pratt Street, Suite 5000, Durham, NC 27710, USA. E-mail: yubin.kang@duke.edu
How to cite this article: Rizzieri D, Paul B, Kang Y. Metabolic alterations and the potential for targeting metabolic pathways in the
treatment of multiple myeloma. J Cancer Metastasis Treat 2019;5:26. http://dx.doi.org/10.20517/2394-4722.2019.05
Received: 5 Jan 2019 First Decision: 30 Jan 2019 Revised: 15 Feb 2019 Accepted: 27 Feb 2019 Published: 3 Apr 2019

Science Editor: Siddiqui Rafat Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Metabolism is defined as the collection of complex biochemical processes that living cells use to generate energy and
maintain their growth and survival. Metabolism encompasses the synthesis and breakdown of glucose, fatty acids,
and amino acids; the generation of energy (ATP); and oxidative phosphorylation. In cancer cells, metabolism can be
commandeered to promote tumor growth and cellular proliferation. These alterations in metabolism have emerged
as an additional hallmark of various cancers. In this review we focus on metabolic alterations in multiple myeloma
(MM) - a malignancy of plasma cells - including derangements in glycolysis, gluconeogenesis, the tricarboxylic acid
cycle, oxidative phosphorylation, and fatty acid/amino acid synthesis and degradation. Particular focus is given
to metabolic alterations that contribute to myeloma cell growth, proliferation and drug resistance. Finally, novel
approaches that target metabolic pathways for the treatment of MM are discussed.

Keywords: Metabolism, alterations, multiple myeloma, treatment

MULTIPLE MYELOMA
Multiple myeloma (MM) is a malignancy of terminally differentiated plasma cells typically characterized by
clonal proliferation of these plasma cells in the bone marrow. MM represents 1% of all malignancies and 18% of
hematologic malignancies in the United States; accounting for an estimated 30,770 new diagnoses and 12,770
[1]
deaths in 2018 alone . Classically, MM results in the secretion of a non-functional monoclonal immunoglobulin

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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