MTOR and neuroendocrine neoplasm: It is not known whether nelfinavir decreases tumor growth in neuroendocrine tumors by inhibition of the PI3K/AKT/mTOR pathway, which can be activated in pancreatic neuroendocrine tumors by mutations in the mTOR pathway [28], or by causing cytotoxicity due to ER dysfunction and protein misfolding in a secretory tumor with high rates of protein synthesis, bioactive hormone release, and turnover.