In addition, hypoxia induces autophagy in pancreatic cancer cells via HIF-1α signaling, facilitating both EMT and the conversion of non-CSCs into PaCSCs, further contributing to tumor dissemination (58) CD133+ PaCSCs themselves exhibit heightened expression of HIF-1α under hypoxia, directly linking this transcription factor to EMT progression and increased migratory capacity (59). This evidence concerns the gene PROM1 and familial pancreatic carcinoma.