In cancerous cells, initiation factors assist in cellular transformation and development of tumors. The survival and growth of cancer is directly related to the modification of initiation factors and is used as a target for pharmaceuticals. Cells need increased energy when cancerous and derive this energy from proteins. Over-expression of initiation factors correlates with cancers, as they increase protein synthesis for proteins needed in cancers. Some initiation factors, such as eIF4E, are important in synthesizing specific proteins needed for the proliferation and survival of cancer. The careful selection of proteins ensures that proteins that are usually limited in translation and only proteins needed for cancer cell growth will be synthesized. This includes proteins involved in growth, malignancy, and angiogenesis. The eIF4E factor, along with eIF4A and eIF4G, also play a role in transitioning benign cancer cells to metastatic.
The largest initiation factor, eIF3, is another significant initiation factor in human cancers. Due to its role in creating the 43S pre-initiation complex, it helps to bind the ribosomal subunit to the mRNA. The initiation factor has been linked to cancers through over-expression. For example, one of the thirteen eIF3 proteins, eIF3c, interacts with and represses proteins used in tumor suppression. Limited expression of certain eIF3 proteins, such as eIF3a an eIF3d, has been proven to decrease the vigorous growth of cancer cells. The over-expression of eIF3a has been linked to breast, lung, cervix, esophagus, stomach, and colon cancers. It is prevalent during early stages of oncogenesis and likely selectively translates proteins needed for cell proliferation. When eIF3a is suppressed, it has shown to decrease the malignancy of breast and lung cancer, most likely due to its role in tumor growth.