When monocytes were differentiated in the presence of lactate with granulocyte-macrophage colony-stimulating factor (GM-CSF), or adenocarcinoma-conditioned media (with elevated lactate and many other mediators), they increased both inflammatory (M1) and regulatory (M2) mediators, consistent with a tumor-associated macrophage (TAM) phenotype (Penny et al., 2016; Paolini et al., 2020). This evidence concerns the gene CSF2 and adenocarcinoma.