Additionally, in cases with a poor prognosis, HIF1A-driven pathways, such as PI3K/AKT, TNF-α, and Wnt, promote tumour proliferation and survival by metabolic reprogramming, as well as upregulation of metastasis-promoting genes such as MMP1, TWIST2, and ITGB1 [112]. Here, MMP1 is linked to neoplasm.