Selected monosaccharides in cancer: Metabolic routing, post-translational modification, immunity and therapeutic potential

Abstract

Metabolic reprogramming and glycosylation remodelling are hallmarks of cancer, and selected monosaccharides are increasingly recognized as key regulators of both processes. Beyond serving as fuels, glucose, galactose, mannose and fructose shape glycosylation, lipid synthesis, antitumour immunity and tumour–host communication. Here, we discuss how these monosaccharides are rerouted across tumour, immune and stromal compartments to generate context-dependent tumour-promoting or antitumour effects. We further evaluate pharmacological opportunities, including metabolic intervention, glycosylation-directed therapy and rational combination strategies, while highlighting major translational barriers such as tumour heterogeneity, biomarker selection and systemic toxicity. This framework positions monosaccharide metabolism as a potential entry point for precision oncology.

Keywords

cancer metabolism / glycosylation / immune regulation / monosaccharides / precision oncology / tumour microenvironment

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2026 The Author(s). Clinical and Translational Discovery published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.