MYC and pancreatic ductal adenocarcinoma: Specifically, NUSAP1 activates the expression of lactate dehydrogenase A (LDHA) by binding to c-Myc and hypoxia-inducible factor (HIF-1α), thereby promoting glycolysis and lactate production, and lactate in turn upregulates the expression of NUSAP1 protein by lysine lactylated modification, forming a NUSAP1–LDHA–glycolysis–lactate feedforward loop that enhances the Warburg effect and metastatic potential in pancreatic ductal adenocarcinoma (PDAC) [103].