White Adipose Tissue and Cancer: Impacts of Doxorubicin and Potential Co-Therapies

Background: White adipose tissue is an essential reservoir of energy that stores and releases fatty acids and secretes hormones, inflammatory cytokines and adipokines in health and cancer. The adipose tissue modulates cancer development and treatment, affecting responsiveness to chemotherapy, quality of life and survival. In addition, adipose tissue is damaged by doxorubicin, which is a non-selective anticancer drug widely used in clinical practice. Aim: This review was focused on the relevance of the white adipose tissue and how it can be affected by doxorubicin and cancer, the mechanisms involved and possible co-therapies that improve white adipose tissue functions. Scope of review: Adipose tissue complexity can influence cancer development, treatment and survival. The adipose tissue secretes adipokines that have paracrine and endocrine effects and may influence tumourigenesis, survival and quality of life in patients with cancer. The chemotherapeutic drug doxorubicin promotes deep impact on the adipose tissue, inhibiting adipogenesis and lipogenesis. Doxorubicin also causes downregulation on peroxisome proliferator-activated receptor gamma (PPARγ) and 5' adenosine monophosphate-AMP-activated protein kinase (AMPK) signalling in white adipose tissue, affecting lipid and glucose metabolism. Some alternative therapies, such as metformin, pioglitazone and physical exercise may contribute to mitigate side effects of doxorubicin. Conclusion: White adipose tissue has a complex and intricate role on cancer and is deeply affected by doxorubicin leading to a deep impact on adipose tissue function and worse quality of life. Potential co-therapies to prevent the side effects of doxorubicin should be studied to improve the quality of life of doxorubicin-treated patients. Open Access Received: 12 March 2020 Accepted: 27 August 2020 Published: 01 September 2020 Copyright © 2020 by the author(s). Licensee Hapres, London, United Kingdom. This is an open access article distributed under the terms and conditions of Creative Commons Attribution 4.0 International License. Immunometabolism 2 of 26