ESM1 regulates critical signaling pathways in cancer development, including the AKT/NF-κB/Cyclin D1, PI3 K/Akt/mTOR, Wnt/β-catenin, DLL4-Notch, AKT/eNOS, and NF-κB/iNOS pathways [178]. This evidence concerns the gene ESM1 and cancer.