The Warburg effect refers to the specific glycolysis metabolism which causes cell proliferation in tumours.180 Metabolisms such as hypoxic TME (O2 pressure <10 mmHg) may induce immunosuppression, immunoresistance, and multiple biological processes.181 Bclaf1 is upregulated under hypoxia and binds to HIF-1α as a transcriptional target. This evidence concerns the gene HIF1A and neoplasm.