The Warburg effect results in a more acidic tumor microenvironment as a result of increased lactic acid production.24 Previous studies investigating how the Warburg effect alters lysosomal trafficking in breast cancer cells found that cells were more invasive and metastatic under acidic conditions and formed larger lysosomes that were localized to the perinuclear region, altering lysosomal morphology and lysosomal trafficking.25,26 We next investigated if NDUFA4L2 altered lysosomal trafficking in RCC4 cells. This evidence concerns the gene COXFA4L2 and breast cancer.