title: Energy sources identify metabolic phenotypes in pancreatic cancer.
abstract: Metabolic reprogramming is one of the emerging hallmarks of cancers. As a highly malignant tumor, pancreatic ductal adenocarcinoma (PDA) is not only a metabolic disease but also a heterogeneous disease. Heterogeneity induces PDA dependence on distinct nutritive substrates, thereby inducing different metabolic phenotypes. We stratified PDA into four phenotypes with distinct types of energy metabolism, including a Warburg phenotype, a reverse Warburg phenotype, a glutaminolysis phenotype, and a lipid-dependent phenotype. The four phenotypes possess distinct metabolic features and reprogram their metabolic pathways to adapt to stress. The metabolic type present in PDA should prompt differential imaging and serologic metabolite detection for diagnosis and prognosis. The targeting of an individual metabolic phenotype with corresponding metabolic inhibitors is considered a promising therapeutic approach and, in combination with chemotherapy, is expected to be a novel strategy for PDA treatment.
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Shunrong
authors.initials: S
authors.lastname: Ji
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Si
authors.initials: S
authors.lastname: Shi
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Wenyan
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Dingkong
authors.initials: D
authors.lastname: Liang
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Qiangsheng
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Guopei
authors.initials: G
authors.lastname: Luo
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Quanxing
authors.initials: Q
authors.lastname: Ni
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China yuxianjun@fudanpci.org xujin@fudanpci.org.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China yuxianjun@fudanpci.org xujin@fudanpci.org.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.|Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yu
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D010641:Phenotype
keywords: Warburg effect; metabolic inhibitor; metabolic phenotype; pancreatic cancer; reverse Warburg effect