PKM and ovarian cancer: Moreover, in niraparib-resistant ovarian cancer cells, the upregulation of PKM and LDHA expression enhances glycolysis, leading to lactic acid accumulation that induces H4 K12 la of RAD23 A. Notably, H4 K12 la enhances the recruitment of MYC to the RAD23 A promoter, further activating RAD23 A transcription and expression.