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Downstream effectors of mTOR including hypoxia-induced factor-1 (HIF-1), hexokinase (HK), pyruvate kinase M2 (PKM2), and enolase2 will then directly stimulate aerobic glycolysis and inhibit oxidative phosphorylation in cancer cells, thus leading to the metabolic reprogramming in PDA tissue (Iqbal et al., 2013
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