ReviewFrontiers in oncology2026
Role of hypoxia-inducible factor - 1 alpha on the progression of cervical intraepithelial neoplasia and cervical cancer: a narrative review.
Review in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cervical cancer represents a global public health problem, hence the importance of optimizing therapeutic options and expanding knowledge of prognostic markers. Clinical and experimental evidence shows that hypoxia-inducible factor (HIF) is a key inducer of aggressive phenotypes in cervical cancer: promoting angiogenesis, invasion, epithelial-mesenchymal transition (EMT), modulation of the immune microenvironment, and contributing to resistance to radiotherapy/chemotherapy in a possible synergistic effect with the human papilloma virus oncogenes. Hypoxic microenvironments that modulate the early activation of HIF pathways may be present in pre-invasive lesions and favor the acquisition of invasive phenotypes that precede invasion. This review highlights the mechanisms of HIF-1α in the progression of cervical intraepithelial neoplasia and cervical cancer. In this regard, HIF-1α is involved in the expression of genes related to angiogenesis, apoptosis and progression such as GLUT1, uPAR, BIRC5, EPO, EpoR, LIMD1, VHL, MET and pro-angiogenic genes (VEGF, PGF, PDGF-β, PAI-1, MMP-2, MMP-9, ANG-1, ANG-2, using pathways such as YAP/TA2. However, the balance between antitumor factors (miR-143) and protumor factors can define the progression of this neoplasia. In the future, the characterization of hypoxia signatures and the evaluation of HIF-1α pathway inhibitors are promising tools for optimizing outcomes in the treatment of cervical cancer, integrated with modern, high-precision radiation therapy techniques and predictive models based on imaging and artificial intelligence, which represent a key pillar of personalized oncology in cervical cancer, with the potential to improve tumor control and reduce toxicity; however, specific clinical trials are still needed to validate their impact on survival and safety.
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