In solid tumors, hypoxia enhances the production of CD39 and CD73, enzymes that generate adenosine, supporting tumor survival.76,77 Hypoxia activates transcription factors like HIF-1α, which regulate these enzymes, maintaining adenosine production under low-oxygen conditions.78 Elevated adenosine levels promote tumor growth, immune suppression, and angiogenesis by binding to A1, A2A, A2B, and A3 receptors.79 This evidence concerns the gene HIF1A and neoplasm.