EMT participates in metastasis development21,22 and formation of cancer stem cells, associated with disease recurrence and chemotherapy and immunotherapy resistance.23-26 In ACC, EMT has been linked to perineural invasion,27 metastasis,28 and radioresistance.29 While AXL overexpression is associated with the better prognosis ACC-II,11 this subtype has frequent pulmonary metastasis, which may be related to EMT.30,31 Given AXL overexpression in the largest ACC subtype group, there is significant biologic rationale to support investigation of AXL-targeted therapy in ACC. This evidence concerns the gene AXL and adrenal cortex carcinoma.