Current and Future Perspectives on Adipo-Oncology: Roles of Adipocytes in Local and Systemic Tumor Regulation

Adipose tissue has traditionally been regarded as an energy-storage organ; however, accumulating evidence indicates that adipocytes actively regulate cancer biology through local and systemic mechanisms. These findings have contributed to the emergence of adipo-oncology, an interdisciplinary field focused on interactions between adipose tissue and cancer. This review summarizes current evidence on the local and systemic roles of adipocytes in tumor progression and discusses how tissue heterogeneity and plasticity may influence these processes. Locally, adipocytes adjacent to tumors may be reprogrammed into cancer-associated adipocytes that promote tumor progression through enhanced lipolysis and inflammatory signaling, paracrine adipokine and cytokine secretion, local lipid transfer, and modulation of stromal and immune cell populations within the tumor microenvironment. Systematically, adipocytes may influence metabolic remodeling, epithelial-mesenchymal transition, invasion, metastasis, therapeutic resistance, and establishment of tumor-promoting niches. Additionally, adipocyte plasticity and epigenetic reprogramming have emerged as important determinants of adipocyte function during cancer progression. Collectively, these findings support a model in which adipocytes function as central regulators of cancer biology at local and systemic levels. A deeper understanding of the molecular basis of adipo-oncology may provide new insights into tumor progression and facilitate the development of metabolic, immunological, and epigenetic therapeutic strategies targeting adipose tissue.