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As metabolic intermediaries change, cell differentiation is not adequately induced, or stress response pathways feedback to restrict or alter the ultimate fate of cells ( 4.1 Tumor glycolytic metabolism and immune response The metabolites and waste products excreted by tumor cells (lactate, CO 2 , H + , NH4 + , nitric oxide, butyrate, polyamines, and ROS, among others) establish acidification of the microenvironment, that is, compatible with cell proliferation and dissemination, promoting several processes such as decreased cell adhesion, angiogenesis, and mesenchyme-epithelial transition (MET) in other tumor models