Autophagy is directly mediated by HDAC4 through deacetylation of the TF CREBZF, which is responsible for the transcription of ATG2 and possibly ATG12. Under normoxic conditions, TP53 leads to a massive decrease in HIF-1a, while expression of HDAC4 and HIF-1a leads to cis-platinum resistance and worsened overall survival in ovarian cancer patients[49]. Here, HDAC4 is linked to ovarian carcinoma.