“…In the past years, an increasing number of molecular alterations involved in SCLC pathogenesis have been reported, including ectopic expression of neuroendocrine regulatory peptides, upregulation of antiapoptotic Bcl-2 proteins, overexpression of myc family oncogenes and extracellular matrix proteins, as well as genetic abnormalities in the tumor suppressor genes TP53 and RB (1,2). In addition, it has been shown that polypeptide growth factors such as hepatocyte growth factor (HGF), fibroblast growth factor-2 (FGF-2), insulin-like growth factor-1 (IGF-1), and stem cell factor (SCF) control key biologic responses in human SCLC cells, including growth and proliferation, chemoresistance, and migration (3)(4)(5)(6). Downstream of activated polypeptide growth factor receptors, activation of 2 major intracellular signaling cascades, the phosphoinositide-3 kinase (PI3K)/ Akt/mTOR, and the mitogen-activated Erk kinase (MEK)/ extracellular signal-regulated kinase (ERK) pathway, have been found to be involved in the survival and proliferation of SCLC (3,(5)(6)(7)(8).…”