Autophagy is a cellular homeostasis mechanism that fuels the proliferation and sur-vival of advanced cancers by degrading and recycling organelles and proteins. Pre -clinical studies have identified that within an established tumor, tumor cell autophagy and host cell autophagy conspire to support tumor growth. A growing body of evidence suggests that autophagy inhibition can augment the efficacy of chemotherapy, targeted therapy, or immunotherapy to enhance tumor shrinkage. First-generation autophagy inhibition trials in cancer using the lysosomal inhibitor hydroxychloroquine (HCQ) have produced mixed results but have guided the way for the development of more potent and specific autophagy inhibitors in clinical tri-als. In this review, we will discuss the role of autophagy in cancer, newly discovered molecular mechanisms of the autophagy pathway, the effects of autophagy modu-lation in cancer and host cells, and novel autophagy inhibitors that are entering clinical trials.
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