10779/crick.11689353.v1 Virginia Schmid Virginia Schmid Veronique N Lafleur Veronique N Lafleur Olivia Lombardi Olivia Lombardi Ran Li Ran Li Rafik Salama Rafik Salama Leandro Colli Leandro Colli Hani Choudhry Hani Choudhry Stephen Chanock Stephen Chanock Peter J Ratcliffe Peter J Ratcliffe David R Mole David R Mole Co-incidence of RCC-susceptibility polymorphisms with HIF cis-acting sequences supports a pathway tuning model of cancer. The Francis Crick Institute 2020 Ratcliffe FC001501 0601 Biochemistry and Cell Biology 0299 Other Physical Sciences 2020-01-22 17:52:09 Journal contribution https://crick.figshare.com/articles/journal_contribution/Co-incidence_of_RCC-susceptibility_polymorphisms_with_HIF_cis-acting_sequences_supports_a_pathway_tuning_model_of_cancer_/11689353 Emerging evidence suggests that dysregulation of oncogenic pathways requires precise tuning in order for cancer to develop. To test this, we examined the overlap between cis-acting elements of the hypoxia-inducible factor (HIF) pathway and cancer-susceptibility polymorphisms as defined in genome-wide association studies (GWAS). In renal cancer, where HIF is constitutively and un-physiologically activated by mutation of the von Hippel-Lindau tumour suppressor, we observed marked excess overlap, which extended to potential susceptibility polymorphisms that are below the conventional threshold applied in GWAS. In contrast, in other cancers where HIF is upregulated by different mechanisms, including micro-environmental hypoxia, we observed no excess in overlap. Our findings support a 'pathway tuning' model of cancer, whereby precise modulation of multiple outputs of specific, activated pathways is important in oncogenesis. This implies that selective pressures to modulate such pathways operate during cancer development and should focus attempts to identify their nature and consequences.