Lastly, in 14q- deleted ccRCC patients with complete (uncensored) survival data, in the relatively rare cases where genetic loss of HIF1A occurs without genetic loss of L2HGDH, the survival is significantly greater than when there is simultaneous genetic loss of HIF1A and L2HGDH. Taken together, the data presented in this study indicate that HIF1α likely has tumor promoting activity in ccRCC (similar to other malignancies), or less likely has a neutral role in terms of tumor progression, and certainly not a tumor suppressive role in ccRCC patients. This evidence concerns the gene L2HGDH and nonpapillary renal cell carcinoma.