New opportunities from the cancer metabolome.

BACKGROUND Metabolomics, the study of all metabolites produced in the body, which often includes flora and drug metabolites, is the omics approach that can be considered most closely related to a patient's phenotype. Metabolomics has a great and largely untapped potential in the field of oncology, and the analysis of the cancer metabolome to identify biofluid markers and novel druggable targets can now be undertaken in many research laboratories. CONTENT The cancer metabolome has been used to identify and begin to evaluate potential biomarkers and therapeutic targets in a variety of malignancies, including breast, prostate, and kidney cancer. We discuss the several standard techniques for metabolite separation and identification, with their potential problems and drawbacks. Validation of biomarkers and targets may entail intensive use of labor and technology and generally requires a large number of study participants as well as laboratory validation studies. The field of pharmacometabolomics, in which specific therapies are chosen on the basis of a patient's metabolomic profile, has shown some promise in the translation of metabolomics into the arena of personalized medicine. SUMMARY The relatively new approach using metabolomics has just begun to enter the mainstream of cancer diagnostics and therapeutics. As this field advances, metabolomics will take its well-deserved place next to genomics, transcriptomics, and proteomics in both clinical and basic research in oncology.