Ceramide is a central molecule of sphingolipid metabolism and is important to maintain cell homeostasis through an orchestrated balance between cell proliferation and apoptosis.47 Studies suggest that cancer cells may acquire the ability to maintain ceramide low levels, bypassing normal metabolic control and then, contributing to chemoresistance.48,49 These data suggest lipid metabolic reprogramming of tumor cells as a possible alternative route supporting triacylglycerol, potentially through modulation of PC by cPLA2 of the Lands cycle. This evidence concerns the gene PLA2G4A and neoplasm.