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. This evidence concerns the gene MIF and cancer.