Deregulation of cell metabolism is an established cancer hallmark that contributes to tumor initiation and progression, as well as tumor heterogeneity. In solid tumors, alterations in different metabolic pathways, including glycolysis, pentose phosphate pathway, glutaminolysis and fatty acid metabolism, support the high proliferative rates and macromolecule biosynthesis of cancer cells. Despite advances in therapy, urothelial tumors still exhibit high recurrence and mortality rates, especially in advanced stages of disease. These tumors harbor gene mutations and expression patterns which play an important role in metabolic reprogramming. Taking into account the unique metabolic features underlying carcinogenesis in these cancers, new and promising therapeutic targets based on metabolic alterations must be considered. Furthermore, the combination of metabolic inhibitors with conventional targeted therapies may improve effectiveness of treatments. This review will summarize the metabolic alterations present in urological tumors and the results with metabolic inhibitors currently available.

细胞代谢失调是已建立的癌症标志，其有助于肿瘤的发生和发展以及肿瘤的异质性。在实体瘤中，包括糖酵解，戊糖磷酸途径，谷氨酰胺分解和脂肪酸代谢在内的不同代谢途径的改变，支持癌细胞的高增殖率和大分子生物合成。尽管疗法取得了进步，但尿路上皮肿瘤仍表现出高复发率和死亡率，特别是在疾病的晚期。这些肿瘤具有基因突变和表达模式，这些基因突变和表达模式在代谢重编程中起重要作用。考虑到这些癌症中致癌作用的独特代谢特征，必须考虑基于代谢改变的新的和有希望的治疗靶标。此外，代谢抑制剂与常规靶向疗法的结合可以提高治疗效果。这篇综述将总结泌尿外科肿瘤中存在的代谢改变以及目前使用的代谢抑制剂的结果。