1. First hit: Loss of function mutations or chromosomal deletions, Epigenetic silencing (promoter methylation)
2. Second hit (Loss of Heterozygosity-LOH): Mitotic recombination, Gene conversion, Chromosomal nondisjunction (LOH) Loss of wild type or normal copy of the gene
Hyperproliferative stress response is mediated through ARF protein
Excessively high levels of E2Fs raise a red flag in the cell, Cell turns on its suicide pathway: E2Fs turn on p14ARF gene, ARF protein associates with and inactivates Mdm2, p53 accumulates and turns on suicide genes, Cell self-destructs (apoptosis)