The impact of metabolic supply lines ‑ and the patterns between them‑on the development of distant metastases in 64 women with breast cancer

Abrahamsen,Oliver; Balslev,Eva; Christensen,Mette; Wibrand,Flemming; Budtz-Jørgensen,Esben; Høgdall,Estrid

doi:10.3892/ol.2022.13447

The impact of metabolic supply lines ‑ and the patterns between them‑on the development of distant metastases in 64 women with breast cancer

Authors:
- Oliver Abrahamsen
- Eva Balslev
- Mette Christensen
- Flemming Wibrand
- Esben Budtz-Jørgensen
- Estrid Høgdall
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Affiliations: Department of Pathology, Molecular Unit, Herlev Hospital, University of Copenhagen, 2730 Herlev, Denmark, Department of Clinical Genetics, Metabolic Laboratory, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark, Department of Public Health, Section of Biostatistics, University of Copenhagen, 1353 Copenhagen, Denmark
Published online on: August 1, 2022 https://doi.org/10.3892/ol.2022.13447
Article Number: 327
Copyright: © Abrahamsen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Cancer cells upregulate their metabolism to underlie the increased malignant activity. This requires an increased amount of ‘metabolic building materials’, for example glucose, amino acids etc., which have the blood circulation as their principal supply lines. Targeting these metabolic supply lines, and thus the availability of metabolic building materials in the blood, therefore carries treatment potential. A central observation is that the malignant alterations comprise great complexity and that compensatory mechanisms exist. Therefore, targeted supply lines should presumably constitute specific patterns to achieve therapeutic effect. The aim of the present study was to investigate if such patterns could be seen to correlate with the development of distant metastases. The study was conducted using a case‑cohort design. In total, 64 women diagnosed with breast cancer between January 2011 and December 2015 were included. Among these, 32 had developed distant metastases and 32 had not. From a blood sample drawn at the time of diagnosis, the levels of glucose (HbA1c), glutamine, arginine and cystathionine were measured. Cox regression was applied to investigate the impact of the supply lines of these ‘building materials’ and specifically the patterns between them on the development of distant metastases. The results demonstrate a significant impact of the investigated metabolic supply lines, centrally in relation to interaction between them and in relation to the impact of the increased cumulated utilization of multiple supply lines simultaneously. In conclusion, the results indicated that the metabolic supply lines may impact clinical outcome, and, in this regard, the results placed a substantial emphasis on the effect of the patterns between these supply lines.

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