Lactate Metabolism: The String-Puller for the Development of Pancreatic Cancer

Since the discovery of the 'Warburg effect' in cancer, lactate is no longer considered merely a metabolic byproduct. It serves as both a metabolic fuel involved in the energy cycle and a signaling molecule that modulates cellular signal transduction. Recent studies have demonstrated that lactate participates in protein lactylation, regulates energy metabolism, reshapes the tumor microenvironment, and facilitates the metastasis of pancreatic cancer. Therefore, targeting lactate metabolism has emerged as a promising strategy to improve therapeutic efficacy and survival rates in pancreatic cancer. In this review, we outline aberrant lactate metabolism and recent advancements in lactylation, and elucidate the biological functions of lactate metabolism in pancreatic cancer, focusing on metabolic reprogramming, angiogenesis, and immune evasion. Additionally, we discuss diagnostic and therapeutic approaches targeting lactate metabolism in pancreatic cancer. Research in this field is critical for understanding the mechanisms driving pancreatic cancer progression and is anticipated to develop novel therapeutic strategies for clinical practice.