In RCC, activation of the mTOR pathway, downstream of the PI3-K/AKT pathway, leads to carcinogenesis by directly promoting the growth of tumor cells or by increasing the expression of hypoxia-inducible factor (HIF)-1α and HIF-2α, which are also involved in renal tumorigenesis (38,39). This evidence concerns the gene EPAS1 and renal cell carcinoma.