Intriguingly, a recent study found that acetoacetate produced by overexpressing BDH2 in liver cancer cells inactivates the macrophage migratory inhibitory factor (MIF), therefore impeding the recruitment of tumour-associated macrophage (TAM), an important target for cancer treatment.36,37 We speculated that acetoacetate affects cancer cells through the paracrine mode of action, other than autocrine. The gene discussed is BDH2; the disease is liver cancer.