Notably, sirtuins have isozyme-specific roles in GBM pathogenesis; for example, SIRT1 promotes tumor proliferation via c-Myc activation and metabolic reprogramming [64], while SIRT3 dynamically regulates lactylation under hypoxia to restore oxidative phosphorylation (OXPHOS) and interacts with TRAP1 to sustain ROS scavenging in glioma stem cells [65]. The gene discussed is MYC; the disease is glioblastoma.