The classical notion of ineffective radiotherapy is primarily attributed to hypoxia.63,64 However, increasing evidence shows that metabolic reprogramming may also be responsible for the development of radioresistance in cancers.5 HIF-1α plays an essential role in tumor cell survival, growth, and metastasis.14 On the one hand, HIF-1α regulates the expression of genes involved in OXPHOS and energy production and promotes the Warburg effect,14 enhanced glycolysis, and lactate secretion in the presence of oxygen in many proliferating tumor cells. The gene discussed is HIF1A; the disease is cancer.