Pancreatic cancer cells rely on a cytoplasmic glutaminolysis pathway producing pyruvate, which requires aspartate transaminase (GOT1, catalyzes aspartate to oxaloacetate), malate dehydrogenase (MDH1, catalyzes malate/oxaloacetate), and malate enzyme (ME1, catalyzes malate/pyruvate) (Figure 2) [38]. Here, MDH1 is linked to pancreatic neoplasm.