CSphCs surviving the combinatorial treatment showed a significant phosphorylation of p235–236 S6 kinase (online supplemental figure 3B), which could follow the activation of RAS/ERK and mammalian target of rapamycin (mTOR) and result in the engagement of the Myc pathway.37 38 The activation of PI3K/AKT and MAPK pathways were confirmed by western blot in tumour specimen-derived subcutaneous xenograft treated with the triple combination (figure 3B and online supplemental figure 3C). This evidence concerns the gene MYC and neoplasm.