This mechanism increases the aggregation of leukocytes and activated platelets and the secretion of inflammatory cytokines, which promote the manifestation of cachectic phenotypes.339 TNF-α and IL-1β can induce the expression of the notch ligand JAG1, and tumor-derived exosomes may also transfer DLL4 to activate notch receptors on distant ECs. Here, TNF is linked to neoplasm.