Inflammation in the lung can also awaken dormant DTCs through the activation of the EMT program induced by ZEB1.133 Active transforming growth factor-β1 (TGF-β1) and periostin derived from endothelial cells are the tumor-promoting factors that enable DTCs to escape cancer dormancy and spark micrometastatic outgrowth.134. The gene discussed is TGFB1; the disease is neoplasm.