Fig. 1

Metabolic adaptation in CSCs and cancer cells. Even when there is a sufficient supply of oxygen, cancer cells frequently adopt the Warburg effect or aerobic glycolysis, relying on glycolysis rather than OXPHOS for ATP production. As a result, the pyruvate is turned into lactate and transferred outside of the cell, where it acidifies the tumor microenvironment and creates an immune-suppressive environment. Additionally, glutamine becomes more important to cancer cells for anabolic processes (such as the production of nucleotides and other amino acids) that promote cell growth and replenish the TCA cycle. In addition, glutamine plays a crucial role in glutathione production, which is essential for chemo-resistance. In cancer, fatty acid oxidation (FAO) and fatty acid synthesis (FAS) are increased to supplement glycolysis for energy and provide the necessary membrane components for accelerated cell development. Furthermore, the composition of their membranes and the signaling that promotes proliferation and invasion in cancer cells rely on the production of cholesterol