Simultaneous activation of multiple STPs confers a poor prognosis. Patients were divided into 3 groups (all low, 1 or 2 high, or all 3 pathways highly activated) according to the activation of PKCα, ERK2 and pERK2, and pAKT and on the basis of the dichotomizations discussed in Figures 2, 3, 4. Patients were statistically more likely to have pan-activation or no activation than would be expected from the individual frequencies of low/high PKCα, ERK2 and pERK2, or pAKT. Survival was worse for those with 1 or 2 highly activated pathways (P = .02) and those with all 3 highly activated pathways (P < .001) than in those with all 3 pathways showing low levels of activation.