Hypoxia or overexpression of HIF-1α reduces E-cadherin expression and increases cell migration, invasion, and metastasis in a Twist-dependent manner, as shown in a study using non-small cell lung cancer, human hypopharyngeal carcinoma, tongue cancer, breast cancer cell lines, and clinical specimens from head and neck squamous cell carcinoma patients [61]. This evidence concerns the gene HIF1A and non-small cell lung carcinoma.