HIF1A and renal cell adenocarcinoma: And the human circular RNA hsa_circRNA_101705 (circTXNDC11) (Yang et al., 2021), hypoxia-induced TRIB3 (HIF-1α-dependent), and the multi-pathway activator Clusterin (synergistic with PI3K/AKT and VEGF pathways) all work together to drive RCC invasion, metastasis, and angiogenesis by activating the MAPK/ERK axis (Hong et al., 2019; Shi et al., 2013).