The role of lactic acid metabolism in anti-tumor immunity

Recent studies have highlighted the pivotal role of lactate metabolism in key oncological processes, such as tumor proliferation, resistance and immune evasion. The discovery of histone lactylation pathways has further underscored the essential link between cellular energy metabolism and epigenetics, offering new insights into cancer biology. This review provides a systematic overview of lactate-immune crosstalk within the tumor microenvironment (TME), discusses the clinical relevance of lactate metabolism and lactylation biomarkers, and highlights emerging therapeutic strategies that target lactate-related pathways. By elucidating the lactate-regulated networks in cancer progression, this review offers insights into the underlying molecular mechanisms and potential pathways for the development of targeted therapies. • Histone lactylation reveals a novel epigenetic mechanism linking lactate metabolism to cancer progression. • We dissects the multifaceted crosstalk between lactate and immune components in the tumor micro-environment, emphasizing clinical relevance of lactate-related biomarkers. • Emerging therapeutic strategies targeting lactate metabolism and lactylation are evaluated as promising avenues for precision oncology.