TWIST1 and cancer: As a result, hypoxia-induced factor-1α (HIF1α) is upregulated, which can induce angiogenesis factors such as VEGF9, 11 but also further promote EMT, which besides downregulation of E-cadherin also leads to expression of EMT-specific genes, for example, Vimentin, Twist, Slug and Zeb1.9, 10 The resulting reduced cell adhesion to neighboring cells allows cancer cells to migrate and escape from hypoxia conditions in the center of the tumor, and in consequence disseminated cancer cells can lead to the formation of metastases.4, 9, 12