Wei et al. concluded that PKM2, upon phosphorylation and dimerization, not only switches tumor cell metabolism from oxidative phosphorylation to aerobic glycolysis but also promotes tumor cell sEV secretion by directly phosphorylating synaptosomal-associated protein 23 (SNAP-23).128 The bidirectional metabolic reprogramming mediated by sEVs occurs between tumor cells and the TME. The gene discussed is PKM; the disease is neoplasm.