Metabolic vulnerabilities in ovarian cancer decoding the nexus between nutrient adaptation and therapy resistance

We discuss how OC cells utilize metabolic pathways-including glycolysis, OXPHOS, glutamine metabolism, and lipid utilization-to promote survival, DNA repair, and immune evasion. Metabolic plasticity enables shifts between nutrient sources, driving resistance to platinum-based agents, PARP inhibitors, and anti-angiogenic therapies. These adaptations vary across subtypes, such as high-grade serous and clear cell carcinomas, and are influenced by specific mutations. Targeting metabolic enzymes-such as GLS, CPT1, OXPHOS complexes, or NAD⁺ synthesis-offers a promising strategic direction. Metabolic profiling may allow stratification of OC patients and pave the way for precision medicine approaches to overcome treatment resistance.