The methylation of deoxyuridine monophosphate (dUMP) to deoxythymidine monophosphate (dMTP) is an essential step for the formation of thymine nucleotides. This process is catalyzed by thymidylate synthase (TS or TYMS). TYMS is an intracellular enzyme that provides the sole de novo source of thymidylate in proliferating cells. Being the exclusive source of dTMP, TS is also an important target for anticancer agents such as 5-fluorouracil (5-FU). 5-FU acts as a TS inhibitor and is active against solid tumors such as colon, breast, head and neck. TS expression may be useful in predicting overall patient survival, but the prognostic value of TS expression continues to be a subject of investigation for different types of cancers.
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