The impact of O2 availability on human cancer

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Abstract
During the past century, the response to hypoxia has emerged as an important phenotypic determinant of a tumour, with repercussions for sensitivity to radiation and chemotherapy. This Timeline provides a historical overview of responses to hypoxia while looking forward to therapeutic strategies that are being developed to exploit them. During the past century it has been established that regions within solid tumours experience mild to severe O2 deprivation owing to aberrant vascular function. These hypoxic regions are associated with altered cellular metabolism, as well as increased resistance to radiation and chemotherapy. As discussed in this Timeline, over the past decade work from many laboratories has elucidated the mechanisms by which hypoxia-inducible factors (HIFs) modulate tumour cell metabolism, angiogenesis, growth and metastasis. The central role played by intra-tumoural hypoxia and HIF in these processes has made them attractive therapeutic targets in the treatment of multiple human malignancies.