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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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it raises FABP3 levels, which in turn lower plasma AA levels by promoting the process of transforming acyls-arachidonoy (AA) to N-arachidonoyl taurine (NAT)

Am J Chin Med 51(1):91105 Li J, Huang Q, Lv M, Ma W, Sun J, Zhong X, Hu R et al (2023b) Role of liensinine in sensitivity of activated macrophages to ferroptosis and in acute liver injury

This route may be considered in some clinical situations where oral therapy is complicated