COL11A1 associated alteration mainly induces changes of PTEN (8.1%), PIK3CA (24.8%), KRAS (37.4%), and BRAF (10.8%) for regulation of RTK-RAS-PI3K signaling pathway (Figure 7A); APC (66.7%) in regulation of Wnt signaling pathway (Figure 7B); SMAD4 (15.5%) for TGF-β signaling pathway (Figure 7C); and ATM (12.5%) and TP53 (53.0%) in alteration of TP53 pathway (Figure 7D) to proliferate the cancer development. This evidence concerns the gene SMAD4 and cancer.