Tumor cells adapt to their high metabolic state by increasing energy production. To this end, current efforts in molecular cancer\ntherapeutics have been focused on signaling pathways that modulate cellular metabolism. However, targeting such signaling\npathways is challenging due to heterogeneity of tumors and recurrent oncogenic mutations. A critical need remains to develop\nantitumor drugs that target tumor specific pathways. Here, we discuss an energy metabolic pathway that is preferentially activated\nin several cancers as a potential target formolecular cancer therapy. In vitro studies have revealed that many cancer cells synthesize\nguanosine triphosphate (GTP), via the de novo purine nucleotide synthesis pathway by upregulating the rate limiting enzyme\nof this pathway, inosine monophosphate dehydrogenase (IMPDH). Non-proliferating cells use an alternative purine nucleotide\nsynthesis pathway, the salvage pathway, to synthesize GTP. These observations pose IMPDH as a potential target to suppress tumor\ncell growth.The IMPDH inhibitor, mycophenolate mofetil (MMF), is an FDA-approved immunosuppressive drug. Accumulating\nevidence shows that, in addition to its immunosuppressive effects, MMF also has antitumor effects via IMPDH inhibition in vitro\nand in vivo.Here, we review the literature on IMPDHas related to tumorigenesis and the use ofMMFas a potential antitumor drug.
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