Preclinical studies in PDAC models showed that hypoxia increases cancer cell proliferation, survival, epithelial-to-mesenchymal transition (EMT), invasiveness, and metastasis, as well as resistance to chemotherapy and radiotherapy, through hypoxia-inducible factor (HIF)-1α -dependent and -independent mechanisms [25, 26, 28–36]. This evidence concerns the gene HIF1A and cancer.