Oncometabolism可被针对性地作为发展低骨髓毒性抗肿瘤药物的目标。乳酸脱氢酶A（LDHA）是Warburg效应的核心，是神经母细胞瘤（NBL）中潜在的代谢改变。高风险NBL孩子的生存率得到了先进的手术、细胞毒性和细胞分化治疗的提高。抗GD2单克隆抗体（mAb）有效地靶向NBL，也被纳入复杂的治疗方案中。然而，高风险NBL的不良临床结局需要改善。这里，我们通过R2onco-genomics平台验证了LDHA在NBL中的预报价值。Kaplan-Meier曲线重新证明了更高的肿瘤LDHA表达与更差的生存率相关。多元统计证实LDHA与年龄、分期和MYCN扩增是独立的。总之，提出了一个分子结构，利用抗GD2 mAbs用于含LDHA抑制剂Oxamate的脂质体的有针对性的输送。该免疫脂质体的开发和临床前测试可能证实针对Warburg效应的有针对性抑制NBL的可行性。影响：研发针对肿瘤代谢的治疗药物。具有靶向性的特异性药物输送。避免正常组织受到深度LDHA抑制的影响。免疫脂质体负载抗代谢物。如果在临床前成功，具有转化潜力。©2023年。作者在国际儿科研究基金会的独家许可下发表。

Oncometabolism can be targeted for the development of less myelotoxic oncotherapeutics. Lactate dehydrogenase A (LDHA) is central to the Warburg effect, a potential oncometabolic shift in neuroblastoma (NBL). Advanced surgical, cytotoxic and cell-differentiating therapies improved survival of children with NBL. Anti-GD2 monoclonal antibodies (mAb) effectively targeting NBL are also incorporated into complex therapies. However, poor clinical outcomes of high-risk NBL require improvements. Here, we verified the pre-reported prognostic value of LDHA expression in NBL using the R2 onco-genomics platform. Kaplan-Meier curves re-demonstrated that higher tumor LDHA expression correlates with worse survival. Multivariate statistics confirmed LDHA is independent from age, stage, and MYCN amplification. In conclusion, a molecular construct is proposed with anti-GD2 mAbs utilized for the targeted delivery of liposomes containing an LDHA inhibitor, Oxamate. Development and preclinical testing of this immunoliposome may validate targeted inhibition of the Warburg effect for NBL. IMPACT: Development of therapeutics against oncometabolism. Targeted specified drug-delivery with mAb. Sparing normal tissues from profound LDHA inhibition. Immunoliposome loaded with an anti-metabolite. If preclinically successful, has translational potential.© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.