Cancer cells employ both conventional oxidative metabolism and glycolytic anaerobic metabolism. However, their proliferation is marked by a shift towards increasing glycolytic metabolism even in the presence of O₂ (Warburg effect). HIF1, a major hypoxia induced transcription factor, promotes a dissociation between glycolysis and the tricarboxylic acid cycle, a process limiting the efficient production of ATP and citrate which otherwise would arrest glycolysis. The Warburg effect also favors an intracellular alkaline pH which is a driving force in many aspects of cancer cell proliferation (enhancement of glycolysis and cell cycle progression) and of cancer aggressiveness (resistance to various processes including hypoxia, apoptosis, cytotoxic drugs and immune response). This metabolism leads to epigenetic and genetic alterations with the occurrence of multiple new cell phenotypes which enhance cancer cell growth and aggressiveness. In depth understanding of these metabolic changes in cancer cells may lead to the development of novel therapeutic strategies, which when combined with existing cancer treatments, might improve their effectiveness and/or overcome chemoresistance.

癌细胞同时使用常规的氧化代谢和糖酵解厌氧代谢。然而，即使在O ₂存在的情况下，它们的增殖也以向糖酵解代谢增加的转变为标志。（Warburg效应）。HIF1是主要的缺氧诱导转录因子，可促进糖酵解和三羧酸循环之间的解离，这是限制ATP和柠檬酸有效产生的过程，否则该酶将阻止糖酵解。Warburg效应还有利于细胞内碱性pH值，它是癌细胞增殖（增强糖酵解和细胞周期进程）和癌症侵袭性（抵抗各种过程（包括缺氧，凋亡，细胞毒性药物和免疫应答）的许多方面的驱动力。这种新陈代谢导致表观遗传学和遗传学改变，并出现了多种新的细胞表型，从而增强了癌细胞的生长和侵略性。深入了解癌细胞中的这些新陈代谢变化可能会导致开发新的治疗策略，