LDHA and familial pancreatic carcinoma: In vitro studies have demonstrated that canagliflozin inhibits pancreatic cancer growth by down-regulating GLUT-1 and LDHA and inhibiting glycolysis through the PI3K/AKT/mTOR/HIF-1α signaling pathway at both the mRNA and protein levels, and the combination of this treatment with gemcitabine has shown improved therapeutic efficacy in pancreatic cancer (39).