Uddin et al. (2010) examined the molecular pathways involved in COX-2 inhibition in ovarian cancer. COX-2, but not COX-1, expression was associated with expression of pAKT in ovarian cancer tumor tissue. In MDAH2774 and SKOV3 cell lines, aspirin and NS-398 also lead to a decrease in proliferation and induction of apoptosis. While the authors did not explore specific EP receptors in this study, EP4 has been shown to activate PI3K/AKT (Hsu et al., 2017). This evidence concerns the gene PTGS1 and neoplasm.