AKT1 and renal cell carcinoma: In conclusion, our studies revealed that BCKDK directly binds to and modulates AKT phosphorylation at both Ser473 and Thr308 sites, activating the downstream AKT/mTOR and AKT/ABCB1 signaling pathways, thereby promoting tumorigenesis, apoptosis, and drug resistance of RCC cells (Figure7).