While this “vascular shutdown” effectively starves tumors, surviving hypoxic cells at the tumor periphery often upregulate pro-angiogenic factors (e.g., VEGF, HIF-1α) and adopt aggressive metabolic phenotypes (e.g., enhanced glycolysis, lactate shuttling), driving recurrence and metastasis (Jung et al., 2021). This evidence concerns the gene VEGFA and neoplasm.