I think that hypoxia microenvironment acts in several ways: (1) leads to the selection of cells that evade apoptosis ; (2) selects cells with glycolytic phenotype (?) ; (3) drive genomic instability and alter DNA damage repair, what increases the chance of new mutations.
It is a very general phenomenon. Tumour cells continuously produce notable amount of cytokine and chemokine which target tumour and adjacent cells via their receptors. It is a very complex and important field which needs serious considerations. Among these factors we can consider, S100 superfamily proteins, HMGB1, TGF-beta and lots of other factors.
Tumor cells are surrounded by immune cells, inflammatory cytokines, and hypoxic microenvironment. Tumor cells harbor the great potential to adapt to the unfavorable microenvironment as selective pressure. further, cancer stem-like cells possess the favorable niche; e.g. melanocytic stem cells localized to the secretory portion of sweat glands in the volar skin are responsible for the development of acral melanoma associated with amplification of the driver oncogene CCND1, which encodes cyclin D1
Article Therapeutic Strategies Targeting Cancer Stem Cells