CSF2 and neoplasm: For example, in the presence of lactate, which is abundant in the tumour milieu as of Warburg effect, CSF2-activated macrophages cannot produce pro-inflammatory cytokines, but rather, generate vast quantities of anti-inflammatory cytokines.46 Extensive use of CSF2 as an adjuvant to anti-cancer vaccines may be thus controversial, unless suited to cancer-specific conditions.47