In accord with results of an earlier study showing a repellent effect of the soluble CA IX ectodomain, it may also destabilise cell–cell cohesion and/or cell-ECM adhesion that are critical for initial tumour growth and metastatic colonisation.32 Second, cell-membrane tethering of CA IX is required for proper execution of pH-regulatory and cell-ECM adhesion functions that protect tumour cells from microenvironmental stresses and contribute to their invasiveness and resistance to cytotoxic therapy. The gene discussed is CA9; the disease is neoplasm.