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D-erythrose is a four-carbon tetrose sugar being investigated for its potential antineoplastic properties. Developed by Meke Innovation Corporation, it is hypothesized to exploit the Warburg effect in cancer cells. The proposed mechanism involves the oxidation of D-erythrose in the cytosol or mitochondria, leading to the production of CO2. In the presence of carbonic anhydrase, this CO2 forms carbonic acid, which facilitates the conversion of lactate to lactic acid. This process induces intracellular acidosis, specifically targeting cancer cells that exhibit high lactate production and leading to cell death. Preclinical studies have shown that D-erythrose inhibits the growth of various cancer cell lines, including breast (BT474, MCF-7), brain (U87mg), pancreatic (Panc-1), lung (LL-2), and colorectal (CT26, SW480) cancers, and significantly reduces tumor weight in vivo.
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