Various factors from the tumor microenvironment in Figure 1, such as hypoxia, ephrin type-A receptor 2 (EPHA2), transforming growth factor -β (TGF-β), twist-related protein 1 (TWIST1), vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs), work together to prompt tumor cells to transition into a mesenchymal state with elevated levels of stemness markers. Here, TWIST1 is linked to neoplasm.