Lactylation: A new direction for tumor-targeted therapy

Lactate, a central metabolite generated during glycolysis, functions not only as a by-product but also as a critical signalling mediator, profoundly influencing tumor progression and cellular destiny. Among the post-translational modifications, lactylation—a novel modification driven by lactate—has emerged as a transformative discovery, reshaping our understanding of lactate's role within the tumor microenvironment (TME). This modification bridges metabolic reprogramming and epigenetic regulation, unveiling previously unexplored dimensions of tumor biology. Recent findings demonstrate that protein lactylation in tumor cells, cancer stem cells, and immune cells infiltrating the TME can modulate transcriptional activities, thereby influencing tumor initiation, progression, and immune evasion. These insights position lactylation as a promising target for new therapeutic strategies in cancer. This review expounds on the underlying mechanisms of lactylation, including the identification of the “writers” and “erasers” involved in protein lactylation, and highlights the physiological significance of lactylation across diverse biological contexts. Furthermore, the paper emphasized on the latest advancements in understanding the modulatory functions of protein lactylation within pathological processes, the potential for targeting lactylation sites, and underscores the scientific significance for future investigative endeavours.