An in-depth understanding of the metabolic changes caused by L-and D-lactate in the tumor may lead to the development of novel anticancer strategies targeting multiple molecular pathways, including MAPK, HIF-1α, NDRG3, PI3K/AKT, NF-κB, and Wnt, which might improve the effectiveness and/or overcome chemoresistance of inventive drugs. This evidence concerns the gene HIF1A and neoplasm.