This may reflect biological effects of transarterial chemoembolisation, which can upregulate HIF-1α, VEGF and regulators of epithelial–mesenchymal transition, thereby exacerbating hypoxia and reinforcing immunosuppression within the tumour microenvironment (Qu et al., 2015; Ader et al., 2008; Fang et al., 2013; Xu et al., 2019; Lin et al., 2021). Here, HIF1A is linked to neoplasm.