Furthermore, these tumor associated macrophages secrete MFGE834, which has been shown to increase epithelial to mesenchymal transition (EMT), invasion and mitosis by activating Twist 1 (Twist-related protein 1)35, and survival and resistance to stress by activating PI3k/AKT (Phosphoinositide 3-kinase/Protein kinase B) pathway35. This evidence concerns the gene TWIST1 and neoplasm.