Twist, the basic helix-loop-helix transcription factor, is involved in the 
process of epithelial to mesenchymal transitions (EMTs), which play an essential 
role in cancer metastasis. Overexpression of Twist or its promoter methylation 
is a common scenario in metastatic carcinomas. Twist is activated by a variety 
of signal transduction pathways, including Akt, signal transducer and activator 
of transcription 3, mitogen-activated protein kinase, Ras, and Wnt signaling. 
Activated Twist upregulates N-cadherin and downregulates E-cadherin, which are 
the hallmarks of EMT. Moreover, Twist plays an important role in some 
physiological processes involved in metastasis, like angiogenesis, invadopodia, 
extravasation, and chromosomal instability. Twist also protects cancer cells 
from apoptotic cell death. In addition, Twist is responsible for the stemness of 
cancer cells and the generation of drug resistance. Recently, targeting Twist 
has gained significant interests in cancer therapeutics. The inactivation of 
Twist by small RNA technology or chemotherapeutic approach has been proved 
successful. Moreover, several inhibitors which are antagonistic to the upstream 
or downstream molecules of Twist signaling pathways have also been identified. 
Development of potential treatment strategies by targeting Twist has a great 
promise in cancer therapeutics.