Importantly, as discussed by Semenza [49], in addition to merely enhancing SCLC cell maintenance by protecting from metabolic stress, HIFs also specify the SCLC cell-state through promoting the expression of genes such as NANOG. Similarly, here we have shown the restriction of glycolysis and promotion of a more oxidative state increases the expression of both stem cell markers such as CD44 and ALDH, as well as genes know to be involved in specifying the stem cell-like state such as c-KIT [50]. This evidence concerns the gene CD44 and small cell lung carcinoma.