Autophagy in Cancer: Mechanisms, Dual Roles, and Therapeutic Targeting
DOI:
https://doi.org/10.48165/jvls.2025.1.2.6Keywords:
Autophagy, Autophagosome ATG proteins, Cancer, Cytoprotective , mTORAbstract
Autophagy is an evolutionarily conserved intracellular degradation mechanism essential for maintaining cellular homeostasis. It regulates the turnover of damaged organelles, misfolded proteins, and metabolic by-products through lysosomal degradation. In cancer biology, autophagy exhibits a context-dependent and paradoxical role. While it prevents malignant transformation by maintaining genomic stability and suppressing inflammation in early tumorigenesis, established tumors often exploit autophagy to sustain survival during metabolic stress, resist anticancer therapies, and support metastasis. This review provides a comprehensive analysis of the molecular mechanisms of autophagy, its dual role in cancer initiation and progression, and its significance in cancer cell metabolism, tumor microenvironment, and therapy resistance. Current therapeutic strategies targeting autophagy both inhibitors and activators are evaluated, including ongoing clinical trials. Finally, the article discusses emerging challenges and future perspectives in utilizing autophagy modulation for cancer therapy.Downloads
References
Abaidullah, R., Ali, S., Summer, M., & Tahir, H. (2025). Molecular mechanisms behind organ-related aging and regulatory effects of natural therapeutics. Cell Biochemistry and Biophysics, 1–28.
Ahmed, M. M., Malachowska, B., & Guha, C. (2025). Radiation-induced tissue regeneration: Pathways, mechanisms, and therapeutic potential. Hematology/Oncology Clinics, 39(2), 431–452.
Ahsan, N., Shariq, M., Surolia, A., Raj, R., Khan, M. F., & Kumar, P. (2024). Multipronged regulation of autophagy and apoptosis: Emerging role of TRIM proteins. Cellular & Molecular Biology Letters, 29(1), 13.
Al-Karmalawy, A. A., Eissa, M. E., Ashour, N. A., Yousef, T. A., Al-Khatib, A. O., & Hawas, S. S. (2025). Medicinal chemistry perspectives on anticancer drug design based on clinical applications (2015–2025). RSC Advances, 15(43), 36441–36471.
Ayub, A., Hasan, M. K., Mahmud, Z., Hossain, M. S., & Kabir, Y. (2024). Dissecting the multifaceted roles of autophagy in cancer initiation, growth, and metastasis. Medical Oncology, 41(7), 183.
Barbosa, F., Cunha, A., Barbosa, J., Faria, J., & Queirós, O. (2025). The dual role of metformin: Repurposing an antidiabetic drug for cancer therapy. Applied Sciences, 15(21), 11576.
Cabrera-Serrano, A. J., Sánchez-Maldonado, J. M., González-Olmedo, C., Carretero-Fernández, M., Díaz-Beltrán, L., Gutiérrez-Bautista, J. F., García-Verdejo, F. J., Gálvez-Montosa, F., López-López, J. A., García-Martín, P., & Pérez, E. M. (2025). Crosstalk between autophagy and oxidative stress in hematological malignancies. Antioxidants, 14(3), 264.
Cao, Z., Tian, K., Ran, Y., Zhou, H., Zhou, L., Ding, Y., & Tang, X. (2024). Beclin-1: A therapeutic target at the intersection of autophagy, immunotherapy, and cancer treatment. Frontiers in Immunology, 15, 1506426.
Comito, G., Ippolito, L., Chiarugi, P., & Cirri, P. (2020). Nutritional exchanges within the tumor microenvironment: Impact on cancer aggressiveness. Frontiers in Oncology, 10, 396.
Corkery, D., Wu, Y. W., & Dowaidar, M. (2021). Guidelines for monitoring autophagy. Autophagy, 17(1), 1–382.
Cosci, I., Salizzato, V., Del Fiore, P., Pigozzo, J., Guarneri, V., Mocellin, S., Ferlin, A., Mathlouthi, S., Piccin, L., & Garofalo, M. (2025). Molecular basis of BRAF inhibitor resistance in melanoma. Pharmaceuticals, 18(8), 1235.
Deng, L., Li, L., Li, Y., Ma, T., Liang, S., & Tian, E. (2025). Targeting autophagy kinases: Mechanisms and therapy. Future Medicinal Chemistry, 1–17.
Dossou, A. S., & Basu, A. (2019). Emerging roles of mTORC1 in autophagy. Cancers, 11(10), 1422.
Duan, Y., Tian, X., Liu, Q., Jin, J., Shi, J., & Hou, Y. (2021). Role of autophagy in cancer immune escape. Cell Communication and Signaling, 19(1), 91.
Dueren, U. K., Wei, A. A. J., Gressler, E., Popp, O., Grumati, P., Selbach, M., Simon, A. K., & Sommer, T. (2025). Autophagy clears ER in inflammation-induced muscle atrophy. bioRxiv.
Durga, Y. K., & Pusapati, R. V. (2025). Drug resistance in glioblastoma: Mechanisms and strategies. Molecular and Clinical Oncology, 24(1), 4.
Filali-Mouncef, Y., Hunter, C., Roccio, F., Zagkou, S., Dupont, N., Primard, C., Proikas-Cezanne, T., & Reggiori, F. (2022). Autophagy, lipid droplets, and liver disease. Autophagy, 18(1), 50–72.
Gaiaschi, L., Bottone, M. G., & De Luca, F. (2024). Combination therapies in glioblastoma. Current Issues in Molecular Biology, 46(12), 14324–14350.
Gao, J., Wang, J., Guan, C., Shi, W., Dong, Q., Sheng, J., Zou, X., Xu, Z., Ge, Y., Huang, Z., & Li, J. (2024). Drug therapy advances in pancreatic cancer. Journal of Cancer, 15(8), 2214.
Gavilán, E., Medina-Guzman, R., Bahatyrevich-Kharitonik, B., & Ruano, D. (2024). ER stress and neurodegeneration. Cells, 13(2), 123.
Gestal-Mato, U., & Herhaus, L. (2024). Autophagy-dependent regulation of MHC-I. Journal of Cellular Biochemistry, 125(11), e30416.
Gómez-Virgilio, L., Silva-Lucero, M. D. C., Flores-Morelos, D. S., Gallardo-Nieto, J., Lopez-Toledo, G., Abarca-Fernandez, A. M., Zacapala-Gómez, A. E., Luna-Muñoz, J., Montiel-Sosa, F., Soto-Rojas, L. O., & Pacheco-Herrero, M. (2022). Autophagy as a regulator of homeostasis and disease. Cells, 11(15), 2262.
Halcrow, P. W., Geiger, J. D., & Chen, X. (2021). Overcoming chemoresistance via pH modulation. Frontiers in Cell and Developmental Biology, 9, 627639.
Hassan, A. M. I. A., Zhao, Y., Chen, X., & He, C. (2024). Blocking autophagy for cancer therapy. International Journal of Molecular Sciences, 25(13), 7459.
He, C. (2022). Autophagy and energy mobilization. Current Biology, 32(12), R684.
Hou, W., Xiao, C., Zhou, R., Yao, X., Chen, Q., Xu, T., & Zhao, C. (2025). Autophagy inhibition and tumor microenvironment. Theranostics, 15(1), 258.
Huang, M., Guoquan, Y., He, B., Zhou, X., Liu, G., & Dong, W. (2025). Microglia and programmed cell death. Frontiers in Cell and Developmental Biology, 13, 1656732.
Iorio, R., Celenza, G., & Petricca, S. (2021). Mitophagy mechanisms and AMPK/ULK1 axis. Cells, 11(1), 30.
Jalali, P., Shahmoradi, A., Samii, A., Mazloomnejad, R., Hatamnejad, M. R., Saeed, A., Namdar, A., & Salehi, Z. (2025). Role of autophagy in cancer. Frontiers in Immunology, 16, 1528230.
Jalouli, M. (2025). Hypoxia-inducible factors in autophagy. International Journal of Molecular Sciences, 26(4), 1752.
Ji, Y., Li, X., Yao, X., Sun, J., Yi, J., Shen, Y., Chen, B., & Sun, H. (2025). Macrophage polarization and therapy strategies. Frontiers in Immunology, 16, 1732718.
Jia, H., Wei, J., Zheng, W., & Li, Z. (2025). Autophagy in cancer stem cells. Journal of Translational Medicine, 23(1), 583.
Kant, R., Kour, H., & Pal Diwakar, R. (2025). Pesticide-induced hazards. Journal of Veterinary and Life Sciences, 1(1), 1–12.
Kim, S. I., Cassella, C. R., & Byrne, K. T. (2021). Tumor burden and immunotherapy. Frontiers in Immunology, 11, 629722.
Kostandy, S. O., Abuiessa, S. A., Helmy, M. M., & Helmy, M. W. (2025). Context-dependent autophagy in cancer. Advances in Medical, Pharmaceutical and Dental Research, 5(1), 38–56.
Liu, S., Yan, H., Diao, J., Zhang, S., & Zhong, Q. (2025). Autophagosome–lysosome fusion processes. Medical Review, 5(4), 297–317.

