Lactate is known to promote cancer growth,47 stimulate angiogenesis,48 and polarize tumor-associated macrophages into a pro-tumor M2 phenotype.49 Alterations in cytokine levels and macrophage polarizations with a pronounced M2 phenotype were observed in the peritoneal cavity of asbestos-exposed Bap1+/− mice and were linked to an increased incidence of MM.50 These findings support a model in which alterations in cellular metabolism due to reduced BAP1 levels may also induce immune system alterations associated with a microenvironment that favors malignant transformation. The gene discussed is BAP1; the disease is Miyoshi myopathy.