ALOX5 and intrahepatic cholangiocarcinoma: Moreover, lipid metabolites such as leukotriene B4 (LTB4), produced via Arachidonate 5-lipoxygenase (ALOX5) from arachidonic acid, recruit M2 macrophages by activating the PI3K pathway, promoting tumor progression in intrahepatic cholangiocarcinoma (67).