These processes involve gene transcription, cell migration ability, cell proliferation, cell death and play a crucial function in normal physiological activities and disease development.19 Recent studies have identified the cAMP signaling pathway as being closely related to tumorigenesis and progression and as a potential therapeutic strategy.20 Epac proteins are guanine nucleotide exchange factors (GEFs) for Rap1 and Rap2 and are associated with tumor development.21–23 Epac inhibitors are already available as a treatment to fight tumors.24 The gene discussed is RAPGEF4; the disease is neoplasm.