In colorectal cancer, hypoxia promotes the binding of phosphorylated PYCR1 to ELK4 and their recruitment to target gene promoters, accelerating tumor progression [43]; ELK4 cooperates with SP1/SP3 to activate LRG1 transcription, thereby enhancing tumor angiogenesis [44]; ELK4 persulfidation promotes an immunosuppressive microenvironment by upregulating AAK-1, which inhibits CD8+ T cell migration [45]; lncRNA SNHG16 facilitates immune evasion through the ELK4/PD-L1 axis [46]. Here, PYCR1 is linked to neoplasm.