Overexpression of Rho kinase 1 (ROCK1) and the G protein RhoA is implicated in breast cancer progression, but oncogenic mutations are rare, and the molecular mechanisms that underlie increased ROCK1 and RhoA expression have not been determined. RhoAbound ROCK1 phosphorylates myosin light chain (MLC), which is required for actin-myosin contractility. RhoA also activates focal adhesion kinase (FAK) signaling. Together, these pathways are critical determinants of the motile and invasive phenotype of cancer cells. We report that hypoxia-inducible factors coordinately activate RhoA and ROCK1 expression and signaling in breast cancer cells, leading to cell and matrix contraction, focal adhesion formation, and motility through phosphorylation of MLC and FAK. Thus, intratumoral hypoxia acts as an oncogenic stimulus by triggering hypoxia-inducible factor → RhoA → ROCK1 → MLC → FAK signaling in breast cancer cells.cytoskeletal reprogramming | metastasis | migration | oxygen | tumor microenvironment I nvasion and metastasis are complex processes leading to dissemination of cancer cells from the primary tumor to distant organs. A critical step is cytoskeletal reprogramming, which transforms rigid, immobile epithelial cells to motile, invasive cancer cells. Members of the Rho family of GTPases play a central role in this process by functioning as molecular switches that control morphogenesis and movement (1). Rho proteins mediate both polymerization of actin (F-actin formation) to create stress fibers, which are antiparallel actin filaments that are crosslinked by myosin, and activation of myosin to trigger contractility (2, 3). Active (GTP-loaded) Rho binds to Rho-associated coiled-coilforming kinase (ROCK), resulting in activation of the kinase (4). This activation mediates the phosphorylation of myosin light chain (MLC) directly as well as indirectly by inhibiting myosin phosphatase (MYPT), leading to actin-myosin contraction (5, 6). ROCK also phosphorylates LIM kinase, which inhibits actin depolymerization (7).For cells to move, force generated by actin-myosin contractility is used to pull on the extracellular matrix (ECM) at focal adhesions, and ECM stiffness promotes the formation of focal adhesions (8). Conversely, substrate stiffness is induced by cell contraction and leads to the activation of focal adhesion kinase (FAK), which is required for mechanosensing and cell motility (9-11). A positive regulatory loop exists between Rho family member A (RhoA) and FAK signaling. In mouse models, FAK plays a critical role in breast cancer progression (12, 13).ROCK1 and RHOA gene expression are coordinately up-regulated in motile cells isolated from metastatic breast cancers (14). Clinical and experimental data indicate that increased expression of RhoA or ROCK1 is associated with breast cancer progression (15)(16)(17)(18)(19). Somatic mutations do not account for RhoA or ROCK1 overexpression in the majority of breast cancers, and the underlying molecular mechanisms remain undefined.The presence of intratumoral hypoxia, i.e., ...