# Limits of aerobic metabolism in cancer cells

## TL;DR

Cancer cells rely on aerobic glycolysis and glutaminolysis because glucose alone cannot meet their metabolic needs due to limitations in mitochondrial energy production.

## Contribution

The paper quantifies the limits of aerobic biosynthesis from glucose and explains why cancer cells must use alternative metabolic pathways.

## Key findings

- Aerobic growth from glucose is limited by the mitochondria's OxPhos capacity and the OxPhos burden of biosynthesis.
- Cancer cells use acetate and certain amino acids to uncouple biosynthesis from NADH generation.
- Common cancer cell lines lack sufficient OxPhos capacity to support growth from glucose alone.

## Abstract

Cancer cells exhibit high rates of aerobic glycolysis and glutaminolysis. Aerobic glycolysis can provide energy and glutaminolysis can provide carbon for anaplerosis and reductive carboxylation to citrate. However, all these metabolic requirements could be in principle satisfied from glucose. Energy can be generated from oxidative phosphorylation (OxPhos) of glucose, anaplerosis can be accomplished using pyruvate carboxylate and citrate can be derived from glucose. Here we investigate why cancer cells do not satisfy their metabolic demands using aerobic biosynthesis from glucose. Based on the typical composition of a mammalian cell we quantify the energy demand and the OxPhos burden of cell biosynthesis from glucose. Our calculation demonstrates that aerobic growth from glucose is feasible up to a minimum doubling time that is proportional to the OxPhos burden and inversely proportional to the mitochondria OxPhos capacity. To grow faster cancer cells must activate aerobic glycolysis for energy generation and uncouple NADH generation from biosynthesis. To uncouple biosynthesis from NADH generation cancer cells can synthesize lipids from carbon sources that do not produce NADH in their catabolism, including acetate and the amino acids glutamate, glutamine, phenylalanine and tyrosine. Finally, we show that cancer cell lines commonly used in cancer research have an OxPhos capacity that is insufficient to support aerobic biosynthesis from glucose. We conclude that selection for high rate of biosynthesis implies a selection for aerobic glycolysis and uncoupling biosynthesis from NADH generation. Any defect or perturbation reducing the OxPhos capacity will exacerbate this selection.