HIF1A and cancer: This exacerbates the sprouting and inefficient growth of new vessels, which leads to a reduced tumor oxygenation.[11, 12] Although several cancers are known to be hypoxic, pancreatic cancers are known to be profoundly so [13] and intratumoral hypoxia is related to a poor outcome.[14–16] This may be due to the increased levels of the survival factor, HIF-1α [15–18], or selection for defects in the apoptotic machinery.[17] Furthermore, the effect of hypoxia may not be mediated solely by the cancer cells, but may also involve the stroma.