Increased HIF-1α activity promotes angiogenesis, metabolic reprogramming, metabolic adaptation, extracellular matrix remodeling, epithelial mesenchymal transformation (EMT), invasion, metastasis, resistance to radiotherapy and chemotherapy, maintenance of cancer stem cell phenotype, immune escape, and protein expression affecting changes in the tumor immune microenvironment during early carcinogenesis (18, 19). The gene discussed is HIF1A; the disease is cancer.