Targeting NAD ⁺ Metabolism to Enhance Radiation Therapy Responses

Nicotinamide adenine dinucleotide (NAD ⁺ ) metabolism is integrally connected with the mechanisms of action of radiation therapy and is altered in many radiation-resistant tumors. This makes NAD ⁺ metabolism an ideal target for therapies that increase radiation sensitivity and improve patient outcomes. This review provides an overview of NAD ⁺ metabolism in the context of the cellular response to ionizing radiation, as well as current therapies that target NAD ⁺ metabolism to enhance radiation therapy responses. Additionally, we summarize state-of-the-art methods for measuring, modeling, and manipulating NAD ⁺ metabolism, which are being used to identify novel targets in the NAD ⁺ metabolic network for therapeutic interventions in combination with radiation therapy.