Mitochondrial dynamics and cancer: mechanisms and targeted therapy

Mitochondria, as key organelles in eukaryotic cells, regulate cellular energy homeostasis and functional integrity through dynamic processes, including fission, fusion, autophagy, and transport, underpinned by precise molecular mechanisms. In healthy cells, the equilibrium of mitochondrial dynamics ensures network quality control and metabolic coordination. In contrast, cancer cells exhibit multi-dimensional dysregulation characterized by hyperactive fission, impaired fusion, and compensatory upregulation of respiratory chain assembly factors, creating a state of "morphology-function decoupling". These alterations drive tumor progression by reprogramming cellular metabolism, promoting proliferation, inhibiting apoptosis, enhancing migration and drug resistance, and facilitating immune evasion. This review elucidates the molecular mechanisms underlying mitochondrial dynamics, their dysregulation in cancer, and their influence on tumor behavior, while also addressing the core challenges of current targeted therapeutic strategies and the novel therapeutic paradigm of "network remodeling", offering new insights into tumor biology and precision cancer therapy.