PKM and colorectal cancer: For example, Ba et al. identified exosome-mediated transfer of circRNA ciRS-122 as a key mechanism driving chemoresistance in colorectal cancer (CRC), where ciRS-122 sponges miR-122 to upregulate PKM2-driven glycolysis and promote oxaliplatin resistance in recipient cells, with therapeutic inhibition of ciRS-122 reversing metabolic reprogramming and restoring drug sensitivity in preclinical models.