In other words, it is possible that there are high constitutively active AKT (high phosphorylation of AKT ser473) and/or ERK1/2 (high phosphorylation of Thr202/Tyr204 for human ERK1 and Thr185/Tyr187 for human ERK2) to maintain the high expression of survivin, XIAP and Mcl-1 for bladder cancer cell survival and proliferation. The gene discussed is MCL1; the disease is urinary bladder cancer.