The PKM2-targeted PET tracer Fluorine F 18 DASA-23 shows potential as an activator in glioblastoma imaging; however, its restricted blood-brain barrier permeability limits both diagnostic sensitivity and potential therapeutic extension (113).In conclusion, these challenges emphasize the need for context-dependent intervention strategies, rigorous preclinical validation, and early-phase clinical trial designs that integrate tumor metabolism, immune modulation, and pharmacodynamics into comprehensive evaluation frameworks. Here, PKM is linked to neoplasm.