Cancer is characterized by somatic mutations that provide a growth and survival advantage. The mutations are a function of chance because of the random nature of mutagenesis. However, the biology in the tumor cells drives the selection of mutations that are advantageous to the cancer.In addition, the tumor environment exerts a selective pressure on the tumor. For example, the hypoxic environment of a tumor induces HIF, stimulating VEGF production, which signals to the non-tumor endothelial cells to stimulate angiogenesis. Witkiewicz et aI. have assessed the association of another non-tumor marker, MCT4, in triple-negative breast cancer (TNBC).
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