Glycosphingolipid synthesis is upregulated by ECHS1-mediated activation of UDP-glucose ceramide glycosyltransferase (UGCG), which activates PI3K/Akt/mTOR signaling and mitochondrial dysfunction, thereby fostering tumor progression and drug resistance; pharmacological inhibition of this axis reverses these effects [94]. This evidence concerns the gene PIK3CA and neoplasm.