Abnormal regulation of cell migration and altered rearrangement of the cytoskeleton are fundamental properties of metastatic cells. The first identified metastasis suppressor NM23-H1, which displays nucleoside-diphosphate kinase (NDPK) activity is involved in these processes. NM23-H1 inhibits the migratory and invasive potential of some cancer cells. Correspondingly, numerous invasive cancer cell lines (eg, breast, colon, oral, hepatocellular carcinoma, and melanoma) display low endogenous NM23 levels. In this review, we summarize mechanisms, which are linked to the anti-metastatic activity of NM23. In human cancer cell lines NM23-H1 was shown to regulate cytoskeleton dynamics through inactivation of Rho/Rac-type GTPases. The Drosophila melanogaster NM23 homolog abnormal wing disc (AWD) controls tracheal and border cell migration. The molecular function of AWD is well characterized in both processes as a GTP supplier of Shi/Dynamin whereby AWD regulates the level of chemotactic receptors on the surface of migrating cells through receptor internalization, by its endocytic function. Our group studied the role of the sole group I NDPK, NDK-1 in distal tip cell (DTC) migration in Caenorhabditis elegans. In the absence of NDK-1 the migration of DTCs is incomplete. A half dosage of NDPK as present in ndk-1 (+/ − ) heterozygotes results in extra turns and overshoots of migrating gonad arms. Conversely, an elevated NDPK level also leads to incomplete gonadal migration owing to a premature stop of DTCs in the third phase of migration, where NDK-1 acts. We propose that NDK-1 exerts a dosage-dependent effect on the migration of DTCs. Our data derived from DTC migration in C. elegans is consistent with data on AWD's function in Drosophila. The combined data suggest that NDPK enzymes control the availability of surface receptors to regulate cell-sensing cues during cell migration. The dosage of NDPKs may be a coupling factor in cell migration by modulating the efficiency of receptor recycling. (2018) 98, 182-189; doi:10.1038/labinvest.2017 published online 18 September 2017 Metastasis suppressors inhibit different steps of metastasis formation without globally influencing primary tumor growth. Current knowledge suggests that the human genome contains 30 genes encoding proteins displaying metastasis suppressor activity. 1 Metastasis inhibitors are either not, or poorly expressed in metastatic colonies. NM23-M1 (non-metastatic clone 23, mouse isoform 1) was identified as the first metastasis suppressor~30 years ago by Patricia Steeg by comparing expression patterns of invasive and non-invasive mouse melanoma cell lines. 2 Although expression of NM23-H1, the human counterpart of NM23-M1 was found to be elevated in primary tumors, downregulation of NM23-H1 expression was observed in multiple examples of metastatic tumors, such as breast, hepatocellular, colon cancer, and melanoma. 3-5 However, it is important to note that in several cancer types (for example, cervical, ovarian, prostate tumors, or hematologic malignancies) po...