In contradiction with a possible role in the earliest steps of tumor progression, Twist and Snai1 expression is induced by hypoxia and known to promote angiogenesis.16–18 From these observations, one could assume that the reactivation of embryonic genes in premalignant tissues helps cells to override oncogene-induced failsafe programs whereas in hypoxic conditions it favors neo-angiogenesis or cell dissemination to less hostile environments, two possibilities that might not be mutually exclusive. Here, TWIST1 is linked to neoplasm.