Despite the profound importance of this transcription factor in regulating multiple facets of hypoxic tumour metabolism, it is evident that in the absence of HIF-1, several adaptive mechanisms may compensate by remodelling metabolism at multiple levels of cellular organization in order to allow cancer cells not just to survive hypoxia, but also to proliferate, invade, and metastasise to distant organs. The gene discussed is HIF1A; the disease is cancer.