Metabolic abnormalities are emerging as an active driver to the development, progression and metastasis of various tumors. In the recent issue of the EMBO Journal, Yang and colleagues identified that succinylacetone (SA) could act as an oncometabolite and that accumulation of SA activates the NRF2/IGF1R axis in hepatocellular carcinoma (HCC) development. These discoveries not only yield great insights in the understanding of tumor biology, but also hold significant clinical ramifications, as these findings may pave a new way for the early diagnosis and treatment of HCC.