PC and neoplasm: These cells produce oxaloacetate, a fundamental factor in maintaining the aspartate level, and also transfer glucose-derived carbons for aspartate biosynthesis, which is critical for cell growth,105 through the preferential use of pyruvate carboxylase (PC).106,107 Furthermore, Cardaci et al. proved that PC inhibition not only reduced the proliferation of SDH-deficient tumor cells in vitro but also weakened the capability of these cells to form tumors in vivo.106 Therefore, PC shares a synthetic lethal interaction with SDH, whereby PC inhibition disturbs the TCA cycle (Fig. 5).