The emerging therapeutic view is that SIRT5 inhibition or malonyl-CoA modulation could selectively target the metabolic fragility of cancer cells, a strategy strengthened by consistent observations across metabolic (Du et al. 2011; Tan et al. 2014), inflammatory (Duan et al., 2025), renal (Baek et al. 2023), and cardiac diseases (Wei et al. 2024; She et al. 2023). Here, SIRT5 is linked to cancer.