NMR‐based metabolomics of biofluids in cancer

Metabolomics is the branch of “omics” technologies that involves high‐throughput identification and quantification of small‐molecule metabolites in the metabolome. NMR‐based spectroscopy of biofluids represents a potential method for non‐invasive characterization of cancer. While the metabolism of cancer cells is altered compared with normal non‐proliferating cells, the metabolome of several biofluids (e.g. blood and urine) reflects the metabolism of the entire organism. This review provides an update on the current status of NMR metabolomics analysis of biofluids with respect to: (i) cancer risk assessment; (ii) cancer detection; (iii) disease characterization and prognosis; and (iv) treatment monitoring. We conclude that many studies show impressive associations between biofluid metabolomics and cancer progression, and suggest that NMR metabolomics can be used to provide information with prognostic or predictive value. However, translation of these findings to clinical practice is currently hindered by a lack of validation, difficulties in biological interpretation, and non‐standardized analytical procedures.