The reduced energy availability in etomoxir-treated HCC cells may reduce the growth rate of HCC cells regardless of PIWIL1 overexpression.50,74 Some previous studies have suggested, besides its inhibition on CPT1, that may have a few off-target effects that may lead to tumor inhibition.28,75 This may also cause tumor inhibition in both wild type and PIWIL1-overexpressing HCC cells. Here, PIWIL1 is linked to hepatocellular carcinoma.