A Narrative Review of the Role of Mitochondria in Cancer: From Metabolic Reprogramming to Therapeutic Targeting

Mitochondria have emerged as critical regulators of cancer biology, transcending their classical role as cellular powerhouses to orchestrate complex metabolic, signaling, and survival pathways essential for tumorigenesis. This review examines the multifaceted role of mitochondria in cancer, integrating initial discoveries with recent advances from recent studies. We explore how mitochondrial DNA mutations, metabolic reprogramming, and alterations in mitochondrial dynamics contribute to malignant transformation, tumor progression, and therapeutic resistance. Mitochondrial dysfunction, long considered a consequence of the Warburg effect, is now recognized as an active driver of oncogenesis through retrograde signaling, oxidative stress modulation, and tumor microenvironment remodeling. The review highlights emerging therapeutic strategies targeting mitochondrial metabolism, including inhibitors of oxidative phosphorylation, mitochondrial-targeted drugs, and approaches exploiting metabolic vulnerabilities. Understanding the complex interplay between mitochondrial function and cancer biology provides a foundation for developing novel diagnostic biomarkers and precision oncology approaches.