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Several mechanisms have been proposed to explain the association between diabetes and cancer, such as hyperglycemia, hyperinsulinemia, increased bioactivity of insulin-like growth factor 1, oxidative stress, sex hormone dysregulation, and chronic inflammation [37]

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Treatment of HCC cells with ADI-PEG20 downregulates the key enzymes of pyrimidine synthesis in the TCA cycle, carbamoyl phosphate synthetase 2, thymine synthase (TS), aspartate transcarbamylase and dihydrooratase (CAD) and malate dehydrogenase 1 (MDH-1) activities, making tumor cells more susceptible to 5-fluorouracil (5-FU)

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