Abstract:Lactylation, as a novel post-translational modification mechanism, has increasingly attracted attention for its role in tumor immune evasion in recent years. Lactylation can be classified into histone and non-histone lactylation. It promotes tumor immune evasion through multiple mechanisms, including metabolic reprogramming of immune cells, promotion of macrophage polarization, regulation of immune cell metabolism and function, and modulation of immune cell signaling pathways. In the context of immunotherapy, lactylation is closely associated with resistance to PD-1 inhibitors and CAR-T cell therapy. Targeting lactate dehydrogenase or specific lactylation sites can significantly enhance the efficacy of immunotherapeutic interventions. This review explores the interplay between lactylation and other post-translational modifications, as well as the potential application prospects of targeting lactylation as a new strategy for tumor immunotherapy. These findings provide a novel perspective for a deeper understanding of the mechanisms of tumor immune evasion and offer a theoretical basis for the development of innovative immunotherapeutic approaches.