Clinical application of ceramide in cancer treatment

  • Kazuki Moro
  • Masayuki NagahashiEmail author
  • Emmanuel Gabriel
  • Kazuaki Takabe
  • Toshifumi Wakai
Review Article


Development of innovative strategies for cancer treatment is a pressing public health issue. Despite recent advances, the mechanisms of cancer progression and the resistance to cancer treatment have not been fully elucidated. Sphingolipids, including ceramide and sphingoshin-1-phosphate, are bioactive mediators that regulate cancer cell death and survival through the dynamic balance of what has been termed the ‘sphingolipid rheostat’. Specifically, ceramide, which acts as the central hub of sphingolipid metabolism, is generated via three major pathways by many stressors, including anti-cancer treatments, environmental stresses, and cytokines. We have previously shown in breast cancer patients that elevated ceramide correlated with less aggressive cancer phenotypes, leading to a prognostic impact. Recent studies showed that ceramide have the possibility of becoming the reinforcing agent of cancer treatment as well as other roles such as nanoparticles and diagnostic biomarker. We review ceramide as one of the key molecules to investigate in overcoming resistance to current drug therapies and in becoming one of the newest cancer treatments.


Apoptosis Cancer Ceramide Drug resistance Sphingosine-1-phosphate 



This work was supported by the Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Scientific Research Grant Number 18K19576 for MN, and 16K15610 for TW. MN was supported by the Uehara Memorial Foundation, Takeda Science Foundation, and Tsukada Medical Foundation. KT was supported by NIH/NCI grant R01CA160688 and Susan G. Komen Investigator Initiated Research Grant IIR12222224.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.


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Copyright information

© The Japanese Breast Cancer Society 2019

Authors and Affiliations

  1. 1.Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigata CityJapan
  2. 2.Department of SurgeryMayo ClinicJacksonvilleUSA
  3. 3.Division of Breast Surgery, Department of Surgical OncologyRoswell Park Comprehensive Cancer CenterBuffaloUSA
  4. 4.Department of Surgery, Jacobs School of Medicine and Biomedical SciencesUniversity at Buffalo, the State University of New YorkBuffaloUSA

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