Elevated lactate levels can inhibit CD8+ T cell cytotoxicity by altering metabolic pathways, contributing to immune evasion in various cancers.[31, 32, 33] This study demonstrates that elevated lactate levels, driven by increased LDH activity, play a central role in shaping the immunosuppressive TME in SCLC. The gene discussed is CD8A; the disease is small cell lung carcinoma.